scholarly journals Lower Diastolic Blood Pressure was Associated with Higher Incidence of Chronic Kidney Disease in the General Population Only in those Using Antihypertensive Medications

2019 ◽  
Vol 44 (5) ◽  
pp. 973-983
Author(s):  
Daisuke Uchida ◽  
Ryo Kido ◽  
Hiroo Kawarazaki ◽  
Masaru Murasawa ◽  
Ayami Ando ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Diastolic Blood Pressure ◽  
Estimated Glomerular Filtration Rate ◽  
Antihypertensive Medications ◽  
Adjusted Risk ◽  
General Japanese Population ◽  
Incidence Of Ckd

Background/Aims: The association of diastolic blood pressure (DBP) with incidence of chronic kidney disease (CKD) in the general population is not well examined. Methods: Using national health check-up database from 2008 to 2011 in the general Japanese population aged 39–74 years, we evaluated the association between DBP and incidence of CKD 2 years later in 127,954 participants without CKD. DBP was categorized by every 5 mm Hg from the lowest (<60 mm Hg) to the highest category (>100 mm Hg) and was further stratified into those with and without antihypertensive medications (BP meds). We calculated the OR for estimating adjusted risk of incident CKD using logistic regression model. Results: Participants were 62% female and 25.9% with BP meds, mean age of 76 years with estimated glomerular filtration rate of 78.2 ± 13.4 and DBP of 76 ± 11 mm Hg. Two years later, 12,379 (9.7%) developed CKD. Compared to DBP 60–64 mm Hg without BP meds as reference, multivariate analysis showed no difference in CKD risk at any DBP category among those without BP meds. However, in those with BP meds, risk increased according to lower DBP from 95 to 60 mm Hg (p for trend 0.05) with OR 1.51 (95% CI 1.14–1.99) in DBP <60 mm Hg. In subgroup analysis within those with or without BP meds, CKD risk was lower at higher DBP (p for trend 0.02) only in those without BP meds. Conclusion: Lower DBP was associated with higher risk of incident CKD only in the general population taking antihypertensive medication.

scholarly journals Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 282
Author(s):  
Hui-Ju Tsai ◽  
Chih-Hsing Hung ◽  
Chih-Wen Wang ◽  
Hung-Pin Tu ◽  
Chiu-Hui Li ◽  
...  
Keyword(s):  
Heavy Metals ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Estimated Glomerular Filtration Rate ◽  
Synergistic Effects ◽  
Blood Lead ◽  
Southern Taiwan ◽  
The Mean ◽  
Traditional Risk Factors

Background: The prevalence of chronic kidney disease (CKD) is increasing annually in Taiwan. In addition to traditional risk factors, heavy metals contribute to the development of CKD. The aim of this study was to investigate associations among heavy metals and proteinuria and CKD in the general population in Southern Taiwan. We also explored the interaction and synergetic effects among heavy metals on proteinuria. Methods: We conducted a health survey in the general population living in Southern Taiwan between June 2016 and September 2018. Seven heavy metals were measured: blood lead (Pb) and urine nickel (Ni), chromium (Cr), manganese (Mn), arsenic (As), copper (Cu), and cadmium (Cd). Proteinuria was measured using reagent strips. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Results: The mean age of the 2447 participants was 55.1 ± 13.2 years and included 977 males and 1470 females. Participants with high blood Pb and high urine Ni, Mn, Cu, and Cd were significantly associated with proteinuria. Interactions between blood Pb and urine Cr, and between urine Cd and Cu, had significant effects on proteinuria. The participants with high blood Pb and high urine Cu were significantly associated with an eGFR of <60 mL/min/1.73 m2. Conclusion: High blood Pb and high urine Cu may be associated with proteinuria and an eGFR of <60 mL/min/1.73 m2. High urine Ni, Mn, and Cd were significantly associated with proteinuria. Co-exposure to Cd and Cu, and Pb and Cr, may have synergistic effects on proteinuria.

Systolic and Diastolic Blood Pressure Analysis in Each Etiology of Pra-Hemodialysis Chronic Kidney Disease

2015 ◽  
Vol 33 ◽  
pp. e41
Author(s):  
Ricardo Adrian Nugraha ◽  
Michael Jonatan ◽  
Pranawa Martosuwignjo ◽  
Sri Murtiwi
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diastolic Blood Pressure ◽  
Pressure Analysis

Serum Markers of Low-Turnover Bone Disease in Mexican Children with Chronic Kidney Disease Undergoing Dialysis

2006 ◽  
Vol 26 (1) ◽  
pp. 78-84 ◽  
Author(s):  
Marcela Ávila-Díaz ◽  
Mario Matos ◽  
Elvia García-López ◽  
María-del-Carmen Prado ◽  
Florencia Castro-Vázquez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Alkaline Phosphatase ◽  
Kidney Disease ◽  
Diastolic Blood Pressure ◽  
Serum Calcium ◽  
Bone Disease ◽  
Linear Growth ◽  
Serum Markers ◽  
Z Score

Background The frequency of low-turnover bone disease (LTBD) in patients with chronic kidney disease (CKD) has increased in past years. This change is important because LTBD is associated with bone pain, growth delay, and higher risk for bone fractures and extraosseous calcifications. LTBD is a histological diagnosis. However, serum markers such as parathyroid hormone (PTH) and calcium levels offer a noninvasive alternative for diagnosing these patients. Objective To describe the prevalence of LTBD in pediatric patients with renal failure undergoing some form of renal replacement therapy, using serum calcium and intact PTH levels as serum markers. Methods In this cross-sectional study, 41 children with CKD undergoing dialysis treatment (31 on continuous ambulatory peritoneal dialysis and 10 on hemodialysis) were included. There were no inclusion restrictions with respect to gender, cause of CKD, or dialysis modality. The children were studied as outpatients. The demographic data, CKD course, time on dialysis, phosphate-binding agents, and calcitriol prescription were registered, as well as weight, height, Z-score for height, linear growth rate, and Z-score for body mass index. Serum calcium, phosphorus, aluminum, PTH, alkaline phosphatase, osteocalcin, glucose, creatinine, urea, cholesterol, and triglycerides were measured. Results There were 20 (48.8%) children with both PTH <150 pg/mL and corrected total calcium >10 mg/dL who were classified as having LTBD[(+)]; the remaining 21 (51.2%) children were classified as having no LTBD[(–)]. The LTBD(+) patients were younger (11.2 ± 2.7 vs 13.2 ± 2.4 years, p < 0.01) but they had no differences regarding Z-scores for height. Linear growth in 6 months was less than expected in both groups (-0.15 ± 0.23 cm/month), but the difference between expected and observed growth was higher in the LTBD(+) group (-0.24 ± 0.14 vs –0.07 ± 0.28 cm/mo, p < 0.03). LTBD(+) patients also had lower serum creatinine (8.69± 2.75 vs 11.19 ± 3.17 mg/dL, p < 0.01), higher serum aluminum levels [median (range) 38.4 (9 – 106) vs 28.1 (9 – 62) μg/L, p < 0.05], and lower systolic blood pressure (112.0 ± 10.3 vs 125.0 ±12.9 mmHg, p < 0.015) and diastolic blood pressure (76.0 ± 9.7 vs 84.5 ± 8.2 mmHg, p < 0.017). A significant correlation was found between PTH and alkaline phosphatase ( r = 0.68, p < 0.001), but not between PTH and aluminum. Conclusion The LTBD(+) biochemical profile was found in 48.8% of the children and was associated with impaired linear growth. Aluminum contamination, evidenced by higher serum aluminum levels, may have had a pathogenic role in these disorders. Higher systolic and diastolic blood pressure levels may be related to higher serum PTH levels.

scholarly journals Masked Hypertension Determined by Self-Measured Blood Pressure at Home and Chronic Kidney Disease in the Japanese General Population: The Ohasama Study

2008 ◽  
Vol 31 (12) ◽  
pp. 2129-2135 ◽  
Author(s):  
Hiroyuki TERAWAKI ◽  
Hirohito METOKI ◽  
Masaaki NAKAYAMA ◽  
Takayoshi OHKUBO ◽  
Masahiro KIKUYA ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Masked Hypertension ◽  
Japanese General Population ◽  
At Home

scholarly journals Determiner of Poor Sleep Quality in Chronic Kidney Disease Patients Links to Elevated Diastolic Blood Pressure, hs-CRP, and Blood-count-based Inflammatory Predictors

2019 ◽  
Vol 11 (1) ◽  
pp. 100-6
Author(s):  
Maulana Antiyan Empitu ◽  
Ika Nindya Kadariswantiningsih ◽  
Mochammad Thaha ◽  
Cahyo Wibisono Nugroho ◽  
Eka Arum Cahyaning Putri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sleep Quality ◽  
Diastolic Blood Pressure ◽  
Blood Count ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Lymphocyte Ratio ◽  
Hs Crp

BACKGROUND: Sleep deprivation is strongly associated with cardiovascular disease (CVD) via sympathetic overstimulation and systemic inflammation in general population. However, the significance of poor sleep quality in chronic kidney disease (CKD) is still underexplored.METHODS: This study assessed the sleep quality of 39 with non-dialysis CKD (ND CKD) patients and 25 hemodialysis CKD (HD CKD) patients using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Poor sleeper was defined as individual with PSQI > 5.RESULTS: The prevalence of poor sleeper (30% vs. 60%, p=0.029) and the cummulative PSQI (ND CKD 4.5±4.4, HD CKD 8±6, p=0.038) are different between ND CKD and HD CKD groups. Among the ND CKD, there are association between short sleep duration (< 5 hours per day) with elevated diastolic blood pressure groups (r=0.421, p<0.05); habitual sleep efficiency with platelet-to-lymphocyte ratio (r= 0.532, p<0.0001); daytime dysfunction with increased hs-CRP (r=0.345, p=0.032) and neutrophil-to-lymphocyte ratio (r=0.320, p=0.046). In HD CKD group, a requirement to use sleep medication was associated with elevated highsensitivity C-reactive protein (hs-CRP) level (r=0.434, p=0.030) and decreased monocyte-to-lymphocyte ratio (r=- 0.410, p=0.042); daytime dysfunction was associated with serum hs-CRP (r=0.452, p=0.023).CONCLUSION: This study revealed that some features of poor sleep quality in CKD patients including low sleep efficiency, daytime dysfunction and requirement to use sleep medication were associated with increased diastolic blood pressure, hs-CRP and blood-count-based inflammatory predictors. Thus, this finding prompt to pay closer attention to sleep complaints in the management of CVD risk factors in CKD patients.KEYWORDS: sleep quality, chronic kidney disease, blood pressure, inflammation

What is the optimal blood pressure level for kidney in the general population?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Ohno ◽  
H Takase ◽  
M Machii ◽  
D Nonaka ◽  
S Takayama ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Kidney Disease ◽  
General Population ◽  
Kidney Function ◽  
Lower Incidence ◽  
Hazard Ratio ◽  
Kidney Dysfunction ◽  
Normotensive Subjects ◽  
Incidence Of Ckd

Abstract Background/Introduction Hypertension induces kidney dysfunction, and vice versa. Furthermore, kidney dysfunction can be a risk factor for cardiovascular diseases as well as end-stage of kidney disease. Although blood pressure (BP) control is necessary to prevent deterioration of kidney function, strict BP control may deteriorate kidney function. Purpose The present observational study investigated effects of BP levels on the incidence of chronic kidney disease (CKD) in the general population. Methods A total of 12,753 subjects with normal kidney function (estimated glomerular filtration rate [eGFR] ≥60 mL/min per 1.73 m2) (male 7,707, mean age 51.8 years) who visited our hospital for an annual physical check-up from April 2010 to March 2018 were enrolled. After baseline examination, subjects were followed up until March 2019 (median 1769 days) with the endpoint being the development of CKD (eGFR&lt;60 mL/min per 1.73 m2). The modified MDRD formula for Japanese was used to calculate eGFR. Hypertension was defined as BP ≥140/90mmHg or the use of antihypertensive medication. Results During the follow-up period, 1,604 subjects developed CKD (26.9 per 1,000 person-years) with the incidence being more frequent in hypertensive (n=3,098) than normotensive (n=9,655) subjects at enrollment (44.2 vs. 21.5 per 1,000 person-years, respectively; hazard ratio [95% confidence interval] from multivariate Cox proportional analysis 1.205 [1.061–1.369]). Hazard ratio of systolic BP at baseline was 1.006 [1.002–1.010] in a multivariate Cox proportional hazard regression model adjusted for possible risk factors. The incidence was lower in subjects without hypertension throughout the follow-up period (normotension group, n=7,866) than those who were diagnosed as having hypertension at least once during the period (hypertension group, n=4,887) (23.1 vs. 32.3 per 1,000 person-years, p&lt;0.001). In the normotension group, subjects with average BP &lt;120/80mmHg had lower incidence of CKD than in those with BP ≥120/80mmHg (17.2 vs. 36.1 per 1,000 person-years, p&lt;0.001). In contrast, in the hypertension group, the incidences of CKD in subjects with average BP &lt;120/80, 120–139/80–89 and ≥140/90mmHg were 34.3, 25.8, and 54.4 per 1,000 person-years, respectively (p&lt;0.001). Moreover, in hypertensive subjects under medication (n=2,002) with average BP &lt;120/80, 120–139/80–89 and ≥140/90mmHg, the incidence of CKD was 65.5, 41.3, and 64.3 per 1,000 person-years, respectively (p&lt;0.01). Conclusions The incidence of CKD was higher in hypertensive than in normotensive subjects. The lower BP was associated with the lower incidence of CKD in normotensive subjects, while strict BP control may increase the risk of CKD in hypertensive subjects. Funding Acknowledgement Type of funding source: None

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