Early Predictors of 15-Year End-Stage Renal Disease in Hypertensive Patients

AIM: The basic aim of this study was to discover the association of End Stage Renal Disease (ESRD) with various risk factors. End Stage Renal Failure is the last stage of the chronic renal failure in which kidneys become completely fail to function.MATERIALS AND METHODS: The data were collected from the patients of renal diseases from three major hospitals in Peshawar, Pakistan. Odds ratio analysis was performed to examine the relationship of ESRD (a binary response variable) with various risk factors: Gender, Diabetic, Hypertension, Glomerulonephritis, Obstructive Nephropathy, Polycystic kidney disease, Myeloma, SLE Nephritis, Heredity, Hepatitis, Excess use of Drugs, heart problem and Anemia.RESULTS: Using odds ratio analysis, the authors found that the ESRD in diabetic patients was 11.04 times more than non-diabetic patients and the ESRD were 7.29 times less in non-hypertensive patients as compared to hypertensive patients. Similarly, glomerulonephritis patients had 3.115 times more risk of having ESRD than non-glomerulonephritis. Other risk factors may also, to some extent, were causes of ESRD but turned out insignificant due to stochastic sample.CONCLUSION: The authors concluded that there is a strong association between ESRD and three risk factors, namely diabetes, hypertension and glomerulonephritis.

Download Full-text

Serum Beta-Trace Protein versus Glomerulus Filtration Rate as a Predictor for Kidney Function among Hypertensive Patients

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v27i2.1618 ◽

2021 ◽

Vol 27 (2) ◽

pp. 127

Author(s):

Ranisa Handayani ◽

Yuyun Widaningsih ◽

Fitriani Mangarengi ◽

Uleng Bahrun

Keyword(s):

Logistic Regression ◽

Renal Disease ◽

Kidney Function ◽

End Stage Renal Disease ◽

Filtration Rate ◽

Hypertensive Patients ◽

Regression Test ◽

Stage Renal Disease ◽

End Stage ◽

Logistic Regression Test

Beta-Trace Protein (BTP) is a low-molecular-weight glycoprotein that can convert prostaglandin H2 into prostaglandin D2 and is associated with the vascular function's alteration. Serum beta-trace protein has been proposed as a promising marker in predicting kidney function in hypertensive patients. This study aimed to analyze the correlation between BTP and glomerulus filtration rate, particularly in hypertensive patients. A cross-sectional survey was conducted on 70 hypertensive participants admitted to Dr. Wahidin Sudirohusodo Hospital from July-August 2019. Beta-trace protein, serum urea, creatinine, blood pressure, and anthropometric were measured. The Glomerulus Filtration Rate (GFR) with Cockcroft Gault was graded using GFR stages. The hypertension was graded according to the category of the European Society of Cardiology (ESC) 2018. A descriptive test, Kruskal-Wallis test, Fisher exact test, Spearman correlation test, and logistic regression test were performed at a confidence level of 95%. Significant differences were found between the age, systole, diastole, blood urea, creatinine, and GFR (p=< 0.05). There was a significant difference between GFR and the degree of hypertension (p=< 0.001), but no differences were found in the mean value of BTP and the degree of hypertension (p=0.348). A significant negative correlation was found between GFR and BTP (p=0.028, r = -0.263). Logistic regression test s showed that the increased BTP led to 2.591 times greater possibility of end-stage renal disease with GFR < 15 mL/min/ 2 1.73 m (crude odds ratio 95% CI 1.168-5.475). Serum beta-trace protein possesses a prognostic ability of glomerulus filtration rate and can be used to predict the odd of end-stage renal disease in hypertensive patients.

Download Full-text

Abstract P517: Dialysis Vintage Longer Than Sixty Months Contributes to Increased Arterial Stiffness and Impaired Diastolic Function in Patients with End-stage Renal Disease

Hypertension ◽

10.1161/hyp.70.suppl_1.p517 ◽

2017 ◽

Vol 70 (suppl_1) ◽

Author(s):

Valentin Calvez ◽

Marco Palladino ◽

Giulio Montefusco ◽

Vincenzo Cesario ◽

Claudia Fofi ◽

...

Keyword(s):

Blood Pressure ◽

Renal Disease ◽

Serum Albumin ◽

Diastolic Function ◽

End Stage Renal Disease ◽

Repeated Measurements ◽

Hypertensive Patients ◽

Dialysis Vintage ◽

Stage Renal Disease ◽

End Stage

Hemodialysis (HD) may induce vascular stiffness through several mechanisms. We sought to determine the role of dialysis vintage (DV) on the development of cardiovascular alterations. We studied 14 patients in chronic HD and 24 newly diagnosed never treated hypertensive patients and 16 normotensive controls. The patients in HD were divided in two groups according to DV: <60-months (DV<60,n=7) or >60-months (DV>60,n=7). After HD session, when dry weight was reached, we evaluated peripheral blood pressure (pBP), the parameters derived by tonometric analysis of the pulse waveform (central blood pressure-cBP-, Subendocardial Viability Ratio-SEVR-, carotid-femoral pulse wave velocity-cf-PWV-) and those derived from echocardiography: ejection fraction (EF-for systolic function) and E/e’ (for diastolic function), and the ultrafiltration volume (UV). Calcium/phosphate (Ca/P) levels, serum albumin, and Kt/V were evaluated retrospectively on repeated measurements over the past 5 years. All the groups were similar for sex and BMI, both DV<60 and DV>60 were older than hypertensives and controls (58.33±3.71 and 59.83±7.98 vs 44.14±1.28 and vs 40.63±2.05 years, respectively, P<0.05). Both DV<60 and DV>60 presented similar levels of Ca/P, serum albumin, Kt/V and UV. pBP was increased and similar to hypertensives in DV>60 vs DV<60 (systolic-pBP: 154.2±4.5 vs 132.5±5.18 mmHg, P<0.01 and diastolic-pBP: 90.4±49 vs 78.5±3.3 mmHg, P<0.01). Likewise cBP was increased and similar to hypertensive patients in DV>60 vs DV<60 (systolic-cBP: 140.8±8.4 vs 111.2±3.36 mmHg, P<0.001 and diastolic-cBP: 88.2±3.73 vs 72.33±7.78 mmHg, respectively, P<0.05). cf-PWV was similar in normotensives, hypertensives and DV<60, and increased only in DV>60 vs DV<60 (9.6±1.4 vs 7.13±1.4 m/s, p<0.05). SEVR and EF were preserved and similar in all the groups. E/e’ was significantly increased only in the groups in HD, however it was higher in DV>60 vs DV<60 (9.16±1.14 vs 6.96±0.72, P<0.01). In conclusion, only patients with DV>60 presented increased aortic stiffness. This was associated to higher BP and diastolic dysfunction. Hence, chronic HD, particularly after 60 months, may play a putative role in developing cardiovascular alterations in patients with end-stage renal disease.

Download Full-text