scholarly journals Association of Urinary Potassium Excretion with Blood Pressure Variability and Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4443
Author(s):  
Sang Heon Suh ◽  
Su Hyun Song ◽  
Tae Ryom Oh ◽  
Hong Sang Choi ◽  
Chang Seong Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Variability ◽  
Potassium Excretion ◽  
Regression Analyses ◽  
Potassium Intake ◽  
Increased Risk ◽  
Dietary Potassium ◽  
Urine Potassium

Dietary potassium intake is a dilemma in patients with chronic kidney disease (CKD). We investigated the association of urine potassium excretion, a surrogate for dietary potassium intake, with blood pressure variability (BPV) and cardiovascular (CV) outcomes in patients with pre-dialysis CKD. A total of 1860 participants from a cohort of pre-dialysis CKD (KNOW-CKD) patients were divided into the quartiles by spot urine potassium-to-creatinine ratio. The first quartile (26.423 ± 5.731 mmol/gCr) was defined as low urine potassium excretion. Multivariate linear regression analyses revealed an independent association of low urine potassium excretion with high BPV (adjusted β coefficient 1.163, 95% confidence interval 0.424 to 1.901). Cox regression analyses demonstrated that, compared to high urine potassium excretion, low urine potassium excretion is associated with increased risk of CV events (adjusted hazard ratio 2.502, 95% confidence interval 1.162 to 5.387) but not with all-cause mortality. In conclusion, low urine potassium excretion is associated with high BPV and increased risk of CV events in patients with pre-dialysis CKD. The restriction of dietary potassium intake should be individualized in patients with pre-dialysis CKD.

Abstract P188: Urinary Sodium and Potassium Excretion and Cardiovascular Diseases in Patients with Chronic Kidney Disease: the Chronic Renal Insufficiency Cohort study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Katherine T Mills ◽  
Jing Chen ◽  
Wei Yang ◽  
Lawrence Appel ◽  
John Kusek ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Renal Insufficiency ◽  
Chronic Renal Insufficiency ◽  
Dietary Sodium ◽  
Potassium Excretion ◽  
Potassium Intake ◽  
Increased Risk ◽  
Sodium And Potassium

Introduction: Chronic kidney disease (CKD) patients are at an increased risk of cardiovascular disease (CVD) compared to the general population. Prior studies have produced contradictory results for the associations of sodium and potassium intake with the risk of CVD. In addition, these associations have not been investigated in patients with CKD. Hypothesis: We assessed the prospective associations between urinary sodium and potassium excretion and CVD event rates among patients with CKD. Methods: The Chronic Renal Insufficiency Cohort Study (CRIC) is a prospective cohort study of 3,939 participants with CKD from seven locations in the United States. Dietary sodium and potassium intake are assessed by averaging three 24-hour urinary measures and calibrating to sex-specific mean 24-hour urinary creatinine excretion. Composite CVD event is defined as myocardial infarction (MI), stroke, or congestive heart failure (CHF). CVD events are reported every six months and confirmed by medical record adjudication. Results: Over an average 6.5 years of follow-up, 660 CVD events were observed. The highest quartile (>197.7 mmol/24 hours) of adjusted sodium excretion had a hazard ratio (HR) of 1.52 (95% confidence interval 1.23, 1.88; p for trend across quartiles 70.5 mmol/24 hours) of adjusted potassium excretion had a HR of 1.46 (1.14, 1.87; p for trend across quartiles 0.0009) for composite CVD events compared to the lowest quartile (≤41.2 mmol/24 hours). When modeled continuously, every 100-mmol/24 hours higher adjusted sodium excretion was associated with an increased HR of 1.25 (1.14, 1.36) for composite CVD events, 1.25 (1.13, 1.39) for CHF, 1.32 (1.08, 1.61) for stroke, and 1.09 (0.93, 1.27) for MI. In addition, every 50-mmol/24 hour higher adjusted potassium intake was associated with an increased HR of 1.25 (1.10, 1.41) for composite CVD events, 1.32 (1.15, 1.52) for CHF, 1.11 (0.81, 1.54) for stroke, and 1.00 (0.79, 1.27) for MI. Conclusions: Our study found that high dietary sodium and potassium are both associated with an increased risk of CVD among patients with CKD. These findings suggest that reductions in high dietary sodium and potassium intake might reduce the risk of CVD among patients with CKD.

scholarly journals FO059MEASURES OF BLOOD PRESSURE VARIABILITY AND THEIR ASSOCIATION WITH CARDIOVASCULAR AND RENAL OUTCOMES IN PRIMARY CARE CHRONIC KIDNEY DISEASE

2019 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Lucy Chambers ◽  
Susil Pallikadavath ◽  
Rupert Major ◽  
David Shepherd ◽  
James Medcalf ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Variability ◽  
Renal Outcomes

scholarly journals The relationships between visit-to-visit blood pressure variability and renal and endothelial function in chronic kidney disease

2014 ◽  
Vol 38 (3) ◽  
pp. 193-198 ◽  
Author(s):  
Chikara Nakano ◽  
Satoshi Morimoto ◽  
Mitsutaka Nakahigashi ◽  
Makiko Kusabe ◽  
Hiroko Ueda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Endothelial Function ◽  
Blood Pressure Variability

scholarly journals SP092CHARACTERISTICS AND CARDIOVASCULAR OUTCOMES OF CHRONIC KIDNEY DISEASE PATIENTS WITH BLOOD PRESSURE VARIABILITY

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i375-i376
Author(s):  
Zorica Dimitrijevic ◽  
Branka Mitic ◽  
Goran Paunovic ◽  
Danijela Tasic ◽  
Stevan Glogovac
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Variability ◽  
Cardiovascular Outcomes

scholarly journals Blood pressure variability and risk of stroke in chronic kidney disease

2020 ◽  
Vol 38 (4) ◽  
pp. 599-602
Author(s):  
Fabio Angeli ◽  
Gianpaolo Reboldi ◽  
Paolo Verdecchia
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Variability

P2641Renal and cardiovascular benefits of treatment with angiotensin receptor blockers in patients with hypertension and chronic kidney disease: A systematic review and meta-analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Burnier ◽  
L R Ruilope ◽  
G B Bader ◽  
S D Durg ◽  
P B Brunel
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Forest Plot ◽  
Cardiovascular Morbidity And Mortality ◽  
Increased Risk ◽  
Receptor Blockers ◽  
The Impact

Abstract Background Blood pressure (BP) control is critical in delaying the progression of chronic kidney disease (CKD), which otherwise results in an increased risk of cardiovascular morbidity and mortality. Angiotensin II receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors, are recommended by several guidelines as first-line treatment for patients with hypertension and CKD. Purpose We reviewed and analysed the effect of ARB treatment on BP and renal outcomes (estimated glomerular filtration rate (eGFR), serum creatinine (SCr), creatinine clearance (CrCl) or proteinuria) in patients with hypertension and CKD with or without diabetes, including large clinical trials such as RENAAL and IDNT. Methods MEDLINE, EMBASE, and BIOSIS databases were searched for literature from the earliest available date to July 2017. Randomised (parallel-group) controlled trials of ≥8 weeks assessed the impact of ARBs on systolic/diastolic BP (SBP/DBP), eGFR, SCr, CrCl or proteinuria were included in the analysis. Meta-analysis (post- versus pre-treatment) and meta-regression were conducted in R-statistical software (v3.4.1) using meta- and metafor-packages. Mean difference (MD, generic inverse variance) with 95% confidence intervals (CIs) was used to pool data for an outcome in a single forest plot. The risk of bias (quality) of included studies was assessed by the six items of the Cochrane instrument. Results Of the 165 articles assessed for eligibility, 24 studies were included in the analysis (19 evaluated ARBs as monotherapy, 4 evaluated ARBs in combination with other antihypertensives and 1 evaluated ARBs both as mono- and combination therapy). Treatment with ARBs as monotherapy for ≥8 weeks to <1 year significantly reduced mean office SBP (MD, −12.60 mmHg; 95% CI, −18.53 to −6.67)/DBP (−6.52 mmHg; −11.27 to −1.77) (p<0.01). BP reduction was also significant (p<0.01) with ARB monotherapy for ≥1 year SBP (−14.84 mmHg; −17.82 to −11.85)/DBP (−10.27 mmHg; −12.26 to −8.27). ARBs also significantly reduced SBP/DBP when combined with other antihypertensive treatments for ≥8 weeks to <1 year as well as for ≥1 year (Figure). Moreover, ARBs induced significant reductions (p<0.01) in proteinuria (≥8 weeks to <1 year [MD, −0.6 g/L; 95% CI, −0.93 to −0.26; ≥1 year [−0.9 g/L; −1.22 to −0.59]), but no significant changes in eGFR, CrCl or SCr levels. The beneficial effect of ARBs was maintained overtime with no significant additional impact on SBP change (estimate: 0.025; 95% CI, –0.14 to 0.19) or eGFR (estimate: 0.068; 95% CI, −0.14 to 0.28; p=0.53). The overall risk of bias was judged to be low. Effect of ARBs on blood pressure changes Conclusion Treatment with ARBs effectively and sustainably lowered BP and proteinuria with no significant change in eGFR in patients with hypertension and CKD with or without diabetes.

Ambulatory blood pressure profile and blood pressure variability in peritoneal dialysis compared with hemodialysis and chronic kidney disease patients

2020 ◽  
Vol 43 (9) ◽  
pp. 903-913 ◽  
Author(s):  
Maria Eleni Alexandrou ◽  
Charalampos Loutradis ◽  
Maria Schoina ◽  
Georgios Tzanis ◽  
Chrysostomos Dimitriadis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Variability ◽  
Pressure Profile ◽  
Blood Pressure Profile
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