scholarly journals Chronic kidney disease and incident apparent treatment-resistant hypertension among blacks: Data from the Jackson Heart Study

2017 ◽  
Vol 19 (11) ◽  
pp. 1117-1124 ◽  
Author(s):  
Rikki M. Tanner ◽  
Daichi Shimbo ◽  
Marguerite R. Irvin ◽  
Tanya M. Spruill ◽  
Samantha G. Bromfield ◽  
...  



Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Eric McClendon ◽  
Solomon Musani ◽  
Sushante Khaire ◽  
Herman Taylor ◽  
Ervin Fox

Background: The presence of chronic kidney disease is greater in African Americans than in non-Hispanic whites. Though there is data to show a relation between endothelial dysfunction and end-stage kidney disease, the relation to mild and moderate chronic kidney disease (particularly in African Americans) is unclear. Methods and Results: Digital arterial tonometry was performed during Exam 2 and 3 of the Jackson Heart Study using the endoPAT2000. Data from digital arterial tonometry included baseline pulse wave amplitude (BPA) as a measure of endothelial tone and reactive hyperemic index (F-RHI) as a measure of endothelial function. For this study, the estimated glomerular filtration rate (eGFR) was calculated using the MDRD equation. Those participants with eGFR < 60 ml/min/1.73m2 were defined as having CKD. Participants with eGFR < 15 ml/min/1.73m2 were excluded from the analysis. Microalbuminuria in this study was defined as a urinary albumin:creatinine ratio ≥ 17mg/g in men and ≥ 25 mg/g in women. We compared the differences in least square means adjusted for age and sex, and adjusted for multiple traditional clinical covariates using a generalized linear model. Results: There were 834 participants in the study population (mean age 58.5 years, 61% women); 87 (10.4%) participants with CKD and 108 (13.0%) with microalbuminuria. In age and sex adjusted samples, we found that both BPA and F-RHI were significantly associated with CKD in the pooled samples. However in multivariable adjusted analysis the relation was no longer significant in either the pooled or sex-specific samples. In the multivariable adusted analysis,BPA was significantly (P=0.036) associated with microalbuminuria in men and F-RHI was weakly significantly (P=0.08) associated with microalbuminuria in women. Conclusion: We found that endothelial dysfunction as measured by digital arterial tonometry is not significantly associated with chronic kidney disease. There is an association of endothelial tone in men and endothelial dysfunction in women with microalbuminuria.





2018 ◽  
Vol 20 (3) ◽  
pp. 438-446 ◽  
Author(s):  
Marguerite R. Irvin ◽  
John N. Booth ◽  
Mario Sims ◽  
Adam P. Bress ◽  
Marwah Abdalla ◽  
...  


2019 ◽  
Vol 32 (9) ◽  
pp. 858-867 ◽  
Author(s):  
Roy O Mathew ◽  
Jerome Fleg ◽  
Janani Rangaswami ◽  
Bo Cai ◽  
Arif Asif ◽  
...  

AbstractBACKGROUNDCentral arteriovenous fistula (cAVF) has been investigated as a therapeutic measure for treatment-resistant hypertension in patients without advanced chronic kidney disease (CKD). There is considerable experience with the use of AVF for hemodialysis in patients with end-stage renal disease (ESRD). However, there is sparse data on the blood pressure (BP) effects of an AVF among patients with ESRD. We hypothesized that AVF creation would significantly reduce BP compared with patients who did not have an AVF among patients with ESRD before starting hemodialysis.METHODSBPs were compared during the 12 months before hemodialysis initiation in 399 patients with an AVF or AV graft created and 4,696 patients without either.RESULTSAfter propensity score matching 1:2 ratio (AVF to no AVF), repeated measures analysis of variance revealed significant reductions of –1.7 mm Hg systolic and –3.9 mm Hg diastolic BP 12 months in patients after AVF creation; P = 0.025 and P &lt; 0.001, respectively, compared with those with no AVF.CONCLUSIONSThese findings suggest that AVF creation results in modest BP reduction in patients with pre-dialysis ESRD who require AVF for eventual hemodialysis therapy. Preferential diastolic BP reduction suggests that greater work is needed to characterize the ideal patient subset in which to use cAVF for treatment-resistant hypertension in those without advanced CKD.



2020 ◽  
Vol 139 ◽  
pp. 110267
Author(s):  
LáShauntá M. Glover ◽  
Crystal Butler-Williams ◽  
Loretta Cain-Shields ◽  
Allana T. Forde ◽  
Tanjala S. Purnell ◽  
...  


2017 ◽  
Vol 31 (7) ◽  
pp. 486-486 ◽  
Author(s):  
A J Shallcross ◽  
M Butler ◽  
R M Tanner ◽  
A P Bress ◽  
P Muntner ◽  
...  


2018 ◽  
Vol 6 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Loretta R. Cain ◽  
LáShauntá Glover ◽  
Bessie Young ◽  
Mario Sims


Hypertension ◽  
2019 ◽  
Vol 73 (4) ◽  
pp. 785-793 ◽  
Author(s):  
Jing Chen ◽  
Joshua D. Bundy ◽  
L. Lee Hamm ◽  
Chi-yuan Hsu ◽  
James Lash ◽  
...  


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