Preeclampsia and the Ten-Year Risk of Incident Chronic Kidney Disease

Background: Although preeclampsia (PE), as an endothelial disorder can lead to renal dysfunction during pregnancy, results of studies focusing on the potential long-term potential effects of PE on renal function are insufficient and those available are controversial. This study investigated the incidence rate and risk of chronic kidney disease (CKD) among women with prior history of PE compared with healthy controls in a long-term population-based study. Methods: This was a prospective population-based cohort study. Subjects were 1,851 eligible women, aged 20–50 years, with at least 1 pregnancy (177 women with prior-PE and 1,674 non-PE controls) selected from among the Tehran-Lipid and Glucose-Study-participants. A pooled-logistic-regression-model and Cox’s-proportional-hazards-models were utilized to estimate the risk of CKD in women of both PE and without PE groups, after further adjustment for confounders. Results: Median and interquartile ranges for follow-up durations of the PE and non-PE groups were 7.78 (5.19–10.40) and 7.32 (4.73–11.00) years, respectively. Total cumulative incidence rates of CKD at the median follow-up time of each group were 35/100,000 (95% CI 25/100,000–50/100,000) and 36/100,000 (95% CI 32/100,000–39/100,000) in PE and non-PE women, respectively (p value = 0.90). Based on pooled-logistic-regression-analysis, OR of CKD progression (adjusted for age, body mass index [BMI], systolic blood pressure [SBP], and diastolic blood pressure [DBP]) for the PE group did not differ, compared to their non-PE counterparts (OR 1.04; p value = 0.80; 95% CI 0.77–1.40). Compared to non-PE women, women with prior PE did not have higher hazard ratios (HRs) of developing CKD in the unadjusted model (unadjusted HR 1.1, 95% CI 0.83–1.69, p = 0.35), results which remained unchanged after adjustment for age, BMI, baseline SBP, and DBP. Conclusion: PE was not found to be a risk factor for CKD. More studies using a prospective cohort design with long-term follow-ups are needed to investigate the relationship between preeclamsia and CKD.

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Safety and tolerability of prescribed usage of Derise® (Darbepoetin Alfa, Hetero) in symptomatic anemia: A Post Marketing Surveillance Study

10.21203/rs.3.rs-23193/v2 ◽

2020 ◽

Author(s):

Shubhadeep Sinha ◽

Vamsi Krishna Bandi ◽

Bala Reddy Bheemareddy ◽

Pankaj Thakur ◽

Sreenivasa Chary ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Adverse Events ◽

Darbepoetin Alfa ◽

P Value ◽

End Of Treatment ◽

Post Marketing Surveillance ◽

Post Marketing

Abstract Background This post marketing surveillance, observational, prospective, safety study evaluated the safety, tolerability and long term immunogenicity of prescribed usage of Darbepoetin alfa, (DA-α, manufactured by Hetero Biopharma) in Indian patients with chronic kidney disease with anemia.Methods All patients with anemia of chronic kidney disease prescribed Hetero-Darbepoetin were the target patient population. The present study gathered the data from 503 Hetero-Darbepoetin alfa prescribed patients. This study collected information of patient demography, patient's medical history, concomitant medications, action taken with respect to Hetero-Darbepoetin-alfa, AE details (AE term, start date, stop date, severity, action taken, outcome and causality), periodic Hemoglobin (Hb) levels and abnormal laboratory tests results until treatment is discontinued or the patient is lost to follow-up. Immunogenicity data was collected in 121 patients at the end of treatment and after 1 year. Statistical analyses were performed to explore and analyze details of individual case safety reports of adverse events such as incidence, severity, seriousness, outcome, duration, action taken, and causality relationship of individual adverse event (AE) to the prescribed study drug. Results 87 AEs were reported in this study and most of them were mild to moderate in intensity. No deaths or serious adverse events (SAEs) were reported in this study. Anti-drug antibodies were not detected in any subject at the end of treatment phase and after 12 months long term follow up period. Baseline mean Hemoglobin value was 8.34 (SD 1.24) g/dL and last visit mean Hemoglobin value was 10.42 (SD 1.28) g/dL. The mean difference between baseline and last visit was 2.10 [2.00, 2.20], statistically significant (p-value <.0001). Conclusions The safety and tolerability of the usage of DA-α (manufactured by Hetero Biopharma) is similar to that reported in the published literature of the innovator. No patients showed anti-drug antibodies after treatment. Additionally, the patients also showed significant improvement in hemoglobin levels, compared to baseline.Clinical Trial Registry Number: CTRI/2017/04/008338 [Registered on CTRI http://ctri.nic.in/Clinicaltrials/login.php : 12/04/2017]; Trial Registered Retrospectively

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Preeclampsia and the risk of chronic kidney disease: a national registry-based cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1174 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

P M Barrett ◽

F P McCarthy ◽

M Evans ◽

M Kublickas ◽

I J Perry ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Absolute Risk ◽

Population Based ◽

National Registry ◽

Medical Birth Register ◽

Increased Risk ◽

History Of

Abstract Background Preeclampsia is associated with increased risk of future cardiovascular disease, but evidence for associations with chronic kidney disease (CKD) has been inconsistent to date. We aimed to measure associations between preeclampsia and long-term CKD in a population-based sample of parous women, and to identify whether the risk differs by CKD subtype. Methods Using data from the Swedish Medical Birth Register, singleton live births from 1973-2012 were identified and linked to data from the Swedish Renal Register and National Patient Register (up to 2013). Preeclampsia was the main exposure of interest and was treated as a time-dependent variable. The primary outcome was maternal CKD, and this was classified into 5 subtypes: hypertensive, diabetic, glomerular/proteinuric, tubulo-interstitial, other/non-specific CKD. Cox proportional hazard regression models were used for analysis. Women with pre-pregnancy comorbidities were excluded. Results The dataset included 1,924,591 unique women who had 3,726,819 singleton pregnancies. The median follow-up was 20.7 (interquartile range 9.9-30.0) years. Overall, 90,964 women (4.7%) experienced preeclampsia and 18,146 (0.9%) developed CKD. Women who had preeclampsia had higher risk of developing any CKD during follow-up (aHR 1.88, 95% CI 1.79-1.98). The risk differed by CKD subtype, and was higher for hypertensive CKD (aHR 3.76, aHR 3.09-4.57), diabetic CKD (aHR 3.45, 95% CI 2.83-4.21) and glomerular/proteinuric CKD (aHR 2.08, 95% CI 1.90-2.29). Women who had preterm preeclampsia, recurrent preeclampsia, or preeclampsia complicated by pre-pregnancy obesity were also at greater risk of any CKD. Conclusions Women with a history of preeclampsia are at increased risk of long-term CKD. The risk is most marked for hypertensive CKD, diabetic CKD, and glomerular/proteinuric CKD. The absolute risk of CKD related to preeclampsia is substantial, and these women may warrant systematic renal monitoring in the years following delivery. Key messages Preeclampsia is an independent predictor of long-term risk of chronic kidney disease in otherwise healthy parous women. Women with a history of preeclampsia may warrant systematic renal monitoring through additional blood pressure, blood glucose, and proteinuria checks.

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DYNAMICS OF FUNCTIONAL STATE OF KIDNEYS IN PATIENTS WITH RESISTANT HYPERTENSION AND CHRONIC KIDNEY DISEASE ACCORDING TO LONG-TERM FOLLOW-UP

International Medical Journal ◽

10.37436/2308-5274-2020-4-1 ◽

2020 ◽

pp. 5-11

Author(s):

O. O. Matova ◽

K. I. Serbeniuk ◽

L. V. Bezrodna ◽

V. B. Bezrodnyi ◽

V. V. Radchenko

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Antihypertensive Therapy ◽

Functional State ◽

Resistant Hypertension ◽

Pressure Control

Resistant hypertension and chronic kidney disease are closely related from a pathogenetic and clinical point of view. To study the dynamics of functional state of kidneys and as well as to identify the predictors of its improvement, 117 patients with resistant hypertension were examined. Dynamic follow−up of patients included monitoring of antihypertensive therapy, blood pressure, biochemical and humoral parameters during 3, 6 and 36 months of treatment. The findings have shown that a significant long−term improvement in blood pressure control in the patients with chronic kidney disease improves their function and also has a nephroprotective effect in patients without any signs of renal damage. The established prognostic value of the higher initial creatinine content for the improvement of renal function in patients with resistant hypertension is stipulated with a positive effect of antihypertensive therapy on the glomerular filtration rate dynamics. The close association between improved renal function and lower baseline levels of interleukin 6 as well as an active renin in the blood may indicate a role for systemic inflammation and renin−angiotensin−aldosterone system activity in the renal dysfunction development. Prolonged improvement in blood pressure control in the patients with resistant hypertension without diabetes is associated with a stable level of urinary albumin excretion, whereas in patients with diabetes, an albuminuria increases over time. The study concluded that independent predictors of improved renal function in patients with resistant hypertension are higher baseline creatinine and lower glomerular filtration rate, lower concentrations of interleukin 6, active renin and plasma potassium. Key words: resistant arterial hypertension, chronic kidney disease, functional state of kidneys, antihypertensive therapy.

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Prevalence and Associated Factors of Chronic Kidney Disease Among Diabetic and Hypertensive Patients at Ambo Town Public Hospitals of West Shewa Zone, Oromia Region, Ethiopia

10.21203/rs.3.rs-1189532/v1 ◽

2022 ◽

Author(s):

Haimanot Ewnetu Hailu ◽

Belachew Dinku ◽

Jimmawork Wondimu ◽

Bilisuma Girma

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Logistic Regression ◽

Kidney Disease ◽

Associated Factors ◽

Public Hospitals ◽

P Value ◽

Hypertensive Patients ◽

Long Duration

Abstract Background: Chronic kidney disease is a global public health important disease that is associated with life threatening outcomes including renal failure and premature mortality unless diagnosed and treated promptly. Diabetes Mellitus and hypertension are the two major causes of chronic kidney disease worldwide. This study is aimed to determine prevalence and associated factors of chronic kidney disease among diabetes mellitus and hypertensive patients at Ambo town public hospitals, EthiopiaMethods: A cross-sectional study was conducted at Ambo University referral and general hospitals on 308 study participants. The participants were interviewed using interviewer administered questionnaire when they come for follow up at a chronic illness follow-up clinic. The patient charts were reviewed to retrieve information regarding medications, blood pressure, serum Creatinine and glucose level. A chronic kidney disease epidemiology collaboration equation was used to estimate Glomerular filtration rate from serum Creatinine. Data were analyzed SPSS version 23 for statistical analysis. Binary logistic regression analysis was used to identify factors associated with chronic kidney disease. Variables with a p-value below 0.2 at bivariable analysis were entered into the multivariable logistic regression model. Multivariable logistic regression analysis was used to examine the association between dependent and independent variable and p-value less than 0.05 was used to declare statistical significance.Results: A total of 308 diabetes mellitus and hypertensive patients were included in the study from Ambo town public hospitals. Of which 156 (50.6%) participants were female with mean (± SD) age of 47.15 ± 12.06 years. The prevalence of chronic kidney disease (stage 3–5) was 20.5% with (95% CI: 16%-25%). Long duration of hypertension (AOR=4.89, 95% CI=1.93-12.40), elevated systolic blood pressure (>140mmHG) (AOR=3.20, 95% CI=1.36-7.51), family history (AOR=3.36, 95% CI=1.56-7.24) and age greater than 55 years (AOR=2.17, 95% CI=1.09-4.31) were predictors of chronic kidney disease.Conclusion: The prevalence of chronic kidney disease was high. Older age, elevated SBP, long duration of hypertension and family history of kidney disease were independent predictors of chronic kidney disease. A preventive plan is mandatory to reduce the disease and complications in the community.

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Sodium Intake and Blood Pressure in Patients with Chronic Kidney Disease: A Salty Relationship

Blood Purification ◽

10.1159/000485154 ◽

2018 ◽

Vol 45 (1-3) ◽

pp. 166-172 ◽

Cited By ~ 4

Author(s):

Fabiana B. Nerbass ◽

Viviane Calice-Silva ◽

Roberto Pecoits-Filho

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Current Knowledge ◽

Sodium Intake ◽

Poor Outcomes ◽

Almost All ◽

Sodium Consumption

Background: Hypertension affects almost all chronic kidney disease patients and is related to poor outcomes. Sodium intake is closely related to blood pressure (BP) levels in this population and decreasing its intake consistently improves the BP control particularly in short-term controlled trials. However, most patients struggle in following a controlled diet on sodium according to the guidelines recommendation due to several factors and barriers discussed in this article. Summary: This review article summarizes the current knowledge related to the associations between sodium consumption, BP, and the risk of cardiovascular disease and chronic kidney disease (CKD); it also provides recommendations of how to achieve sodium intake lowering. Key Messages: Evidences support the benefits in decreasing sodium intake on markers of cardiovascular and renal outcomes in CKD. Trials had shorter follow-up and to maintain long-term sodium intake control is a major challenge. Larger studies with longer follow-up looking at hard endpoints will be important to drive future recommendations.

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Dietary Micronutrients and Risk of Chronic Kidney Disease: A Cohort Study with 12 Year Follow-Up

Nutrients ◽

10.3390/nu13051517 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1517

Author(s):

Juyeon Lee ◽

Kook-Hwan Oh ◽

Sue-Kyung Park

Keyword(s):

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Epidemiologic Study ◽

Population Based ◽

Dietary Guidelines ◽

Dietary Intakes ◽

Increased Risk ◽

Ckd Stage

We investigated the association between dietary micronutrient intakes and the risk of chronic kidney disease (CKD) in the Ansan-Ansung study of the Korean Genome and Epidemiologic Study (KoGES), a population-based prospective cohort study. Of 9079 cohort participants with a baseline estimate glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 and a urine albumin to creatinine ratio (UACR) <300 mg/g and who were not diagnosed with CKD, we ascertained 1392 new CKD cases over 12 year follow-up periods. The risk of CKD according to dietary micronutrient intakes was presented using hazard ratios (HRs) and 95% confidence intervals (95% CIs) in a full multivariable Cox proportional hazard models, adjusted for multiple micronutrients and important clinico-epidemiological risk factors. Low dietary intakes of phosphorus (<400 mg/day), vitamin B2 (<0.7 mg/day) and high dietary intake of vitamin B6 (≥1.6 mg/day) and C (≥100 mg/day) were associated with an increased risk of CKD stage 3B and over, compared with the intake at recommended levels (HR = 6.78 [95%CI = 2.18–21.11]; HR = 2.90 [95%CI = 1.01–8.33]; HR = 2.71 [95%CI = 1.26–5.81]; HR = 1.83 [95%CI = 1.00–3.33], respectively). In the restricted population, excluding new CKD cases defined within 2 years, an additional association with low folate levels (<100 µg/day) in higher risk of CKD stage 3B and over was observed (HR = 6.72 [95%CI = 1.40–32.16]). None of the micronutrients showed a significant association with the risk of developing CKD stage 3A. Adequate intake of micronutrients may lower the risk of CKD stage 3B and over, suggesting that dietary guidelines are needed in the general population to prevent CKD.

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Association between systolic blood pressure trajectories and hypertension risk at late adolescence: results from 10-year longitudinal follow-up in Chinese boys

BMJ Open ◽

10.1136/bmjopen-2020-042594 ◽

2021 ◽

Vol 11 (4) ◽

pp. e042594

Author(s):

Xijie Wang ◽

Bin Dong ◽

Sizhe Huang ◽

Zhaogeng Yang ◽

Jun Ma ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Late Adolescence ◽

Population Based ◽

Incidence Rates ◽

Hypertension Risk ◽

Logit Regression ◽

Binomial Regression ◽

Physical Examinations

ObjectiveTo identify various systolic blood pressure (SBP) trajectories in Chinese boys between 7 and 18 years of age, and to explore their high blood pressure (HBP) risk in their late adolescence years.Design and settingsA population-based cohort study in Guangdong, China.Participants4541 normal tensive boys who started primary school in 2005 in Zhongshan, Guangdong were included.OutcomesBlood pressure and relevant measurements were obtained by annual physical examinations between 2005 and 2016. HBP was defined by SBP or diastolic blood pressure ≥95th percentile for children under 13, and BP ≥130/80 mm Hg for children ≥13 years old. Logit regression for panel data and log-binomial regression model was used to estimate the risk of HBP among SBP trajectory groups.ResultsFour distinct SBP trajectory groups via group-based trajectory modelling: low stable (13.0%), low rising (42.4%), rising (37.4%) and high rising (7.3%). The overall incidence rates of HBP during the follow-up ranged from 40.24 (95% CI 36.68 to 44.19)/1000 person-years in the low stable group to 97.08 (95% CI 94.93 to 99.27)/1000 person-years in the high rising group. Compared with children with low stable SBP, those of other SBP trajectories suffered 3.05 (95% CI 2.64 to 3.46) to 4.64 (95% CI 4.18 to 5.09) times of higher risk of HBP in their late adolescence, regardless of their age, body mass index and BP level at baseline.ConclusionsSubgroups of SBP trajectories existed in Chinese boys, and are related to hypertension risk at late adolescence. Regular physical examinations could help identify those with higher risks at the beginning of pubertal growth.

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Obesity, Abdominal Obesity and Chronic Kidney Disease in Young Adults: A Nationwide Population-Based Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10051065 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1065

Author(s):

Eun Hui Bae ◽

Sang Yeob Lim ◽

Jin-Hyung Jung ◽

Tae Ryom Oh ◽

Hong Sang Choi ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Young Adults ◽

Kidney Disease ◽

Abdominal Obesity ◽

Population Based ◽

Baseline Body Mass Index ◽

Increased Risk ◽

Baseline Examination ◽

New Onset

Obesity has become a pandemic. It is one of the strongest risk-factors of new-onset chronic kidney disease (CKD). However, the effects of obesity and abdominal obesity on the risk of developing CKD in young adults has not been elucidated. From a nationwide health screening database, we included 3,030,884 young adults aged 20–39 years without CKD during a baseline examination in 2009–2010, who could follow up during 2013–2016. Patients were stratified into five levels based on their baseline body mass index (BMI) and six levels based on their waist circumference (WC; 5-cm increments). The primary outcome was the development of CKD. During the follow up, until 2016, 5853 (0.19%) participants developed CKD. Both BMI and WC showed a U-shaped relationship with CKD risk, identifying the cut-off values as a BMI of 21 and WC of 72 cm in young adults. The obesity group (odd ratio [OR] = 1.320, 95% confidence interval [CI]: 1.247–1.397) and abdominal obesity group (male WC ≥ 90, female WC ≥ 85) (OR = 1.208, 95%CI: 1.332–1.290) showed a higher CKD risk than the non-obesity or non-abdominal obesity groups after adjusting for covariates. In the CKD risk by obesity composite, the obesity displayed by the abdominal obesity group showed the highest CKD risk (OR = 1.502, 95%CI: 1.190–1.895), especially in those under 30 years old. During subgroup analysis, the diabetes mellitus (DM) group with obesity or abdominal obesity paradoxically showed a lower CKD risk compared with the non-obesity or non-abdominal obesity group. Obesity and abdominal obesity are associated with increased risk of developing CKD in young adults but a decreased risk in young adults with diabetes.

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Optimal blood pressure for patients with chronic kidney disease: a nationwide population-based cohort study

Scientific Reports ◽

10.1038/s41598-021-81328-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

You-Bin Lee ◽

Ji Sung Lee ◽

So-hyeon Hong ◽

Jung A. Kim ◽

Eun Roh ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Cardiovascular Events ◽

Antihypertensive Treatment ◽

Antihypertensive Agents ◽

Population Based ◽

Adverse Outcomes ◽

Optimal Blood Pressure ◽

Stage Renal Disease

AbstractThe effect of blood pressure (BP) on the incident cardiovascular events, progression to end-stage renal disease (ESRD) and mortality were evaluated among chronic kidney disease (CKD) patients with and without antihypertensive treatment. This nationwide study used the Korean National Health Insurance Service-Health Screening Cohort data. The hazards of outcomes were analysed according to the systolic BP (SBP) or diastolic BP (DBP) among adults (aged ≥ 40 years) with CKD and without previous cardiovascular disease or ESRD (n = 22,278). The SBP and DBP were ≥ 130 mmHg and ≥ 80 mmHg in 10,809 (48.52%) and 11,583 (51.99%) participants, respectively. During a median 6.2 years, 1271 cardiovascular events, 201 ESRD incidents, and 1061 deaths were noted. Individuals with SBP ≥ 130 mmHg and DBP ≥ 80 mmHg had higher hazards of hypertension-related adverse outcomes compared to the references (SBP 120–129 mmHg and DBP 70–79 mmHg). SBP < 100 mmHg was associated with hazards of all-cause death, and composite of ESRD and all-cause death during follow-up only among the antihypertensive medication users suggesting that the BP should be < 130/80 mmHg and the SBP should not be < 100 mmHg with antihypertensive agents to prevent the adverse outcome risk of insufficient and excessive antihypertensive treatment in CKD patients.

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Abstract 211: Variation of NEDD4L is Associated with Hypertension in Chinese Hans Chronic Kidney Disease Patients

Hypertension ◽

10.1161/hyp.62.suppl_1.a211 ◽

2013 ◽

Vol 62 (suppl_1) ◽

Author(s):

Cheng Wang ◽

Jun Zhang ◽

Cuicui Li ◽

Wenyu Gong ◽

Tanqi Lou

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Logistic Regression ◽

Kidney Disease ◽

Blood Pressure Monitoring ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Functional Studies ◽

Chi Squared ◽

The Relationship

Background: Neural precursor cell expressed developmentally down-regulated 4-like (NEDD4L) is a candidate gene for hypertension, and carriers of an intact NEDD4L C2-domain,encoded by the NEDD4L rs4149601 (G/A) GG genotype, together with the C-allele of the NEDD4L rs2288774 (C/T) polymorphism have been found be associated with hypertension both in African Americans and whites. However, there is no data on the relationship between polymorphism of NEDD4L rs4149601 and rs2288774 and hypertension in Chinese chronic kidney disease (CKD) patients. The purpose of the current study was to investigate the relationship between the variation of NEDD4L rs4149601, rs2288774 and hypertension in CKD patients. Methods: A total of 546 Chines Hans CKD patients were enrolled in our study. The SNPs were genotyped using PCR-based techniques. All patients underwent ambulatory blood pressure monitoring, and clinical data were also collected. Multivariate logistic regression analysis was used to identify the relationship between polymorphisms and hypertension. Results: 506 patients carried GG/GA genotype and 30 carried AA genotype. Rs4149601 AA genotype carriers had significantly higher rate of hypertension (68.3% vs 46.2%, P = 0.022) than GG/GA genotype carriers by Chi-squared test. AA genotype carriers also had a higher day-time and bedtime systolic blood pressure (142±16 vs 135±23, P=0.036; 137±18 vs 127±13, P=0.022, respectively) when compared with GG/GA genotype carriers. AA genotype [OR= 3.08, 95% CI (1.06-9.80)], lowever eGFR [OR=0.98, 95% CI (0.97-0.99)], older age [OR=1.03, 95% CI (1.01-1.05)] were independently associated with hypertension in CKD patients by multivariate logistic regression. However, No difference was found in blood pressure with rs2288774 TT/TC/CC genotypes, and no difference was found in the incidence of hypertension among patients with three genotypes. Conclusions: Our results suggested 4149601AA genotype of NEDD4L may be associated with hypertension in CKD patients, and further genetic and functional studies are required to understand its role in the manifestation of hypertension in Chinese CKD patients.

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