Diagnostic value of a single blood pressure reading for the detection of latent hypertension in children with chronic kidney diseases

Over 30,000 publications have been published about the vasoconstrictor endothelin-1, which was identified by Yanagisawa and co-workers in 1988. While the evidence is quite compelling, scientists can only speculate on how the endothelin (ET) system affects blood pressure and renal function at this time. ET system involvement in chronic kidney diseases (CKD) pathogenesis is now the most often employed treatment method. ET1, ET2, and ET3 are all members of the endothelin family. Endothelium, renal, and smooth muscle cells all generate ET-1, a significant isoform found in both cardiovascular and renal systems.Kidney cells act on, and contain, ET-1. The ETA receptor is found in the brain and medulla, but not in the vasa recta or glomeruli. Epithelial and endothelial cells contain the ETB receptor, which is most prominent in collecting duct cells. 3 In several experiments, ET-1 has been established to be largely a preglomerular vasoconstrictor. Mesangial proliferation, contraction, and collagen production are regulated by ET-1 and ETB receptors in podocytes. The epithelium in the collecting duct cells in the medulla is important in controlling Na excretion and BP. Without the ET-1 gene, the mice have hypertension and reduced natriuresis in response to salt loading. Et-1, ETB receptor, and hypertension are shown in mice that have lost the ETB receptor gene. There is no correlation between blood pressure regulation and natriuresis.Combined disruption of the ETA and ETB receptors has greater effects on blood pressure and Na reabsorption than when ETB receptor activity is missing. It appears that the ETB receptor doesn't work until ETB is present. Collecting duct-derived ET receptors reduces the transport of sodium. Src kinase and MAPK1/2 decrease epidermal Na channel (ENaC) function, decreasing water and salt reabsorption. Moreover, inner medullary collecting duct cells and vasa recta-bearing cells will release NO, which decreases sodium transport.

Download Full-text

SP119EVALUATION OF AMBULATORY BLOOD PRESSURE MEASUREMENT IN A COHORT OF PATIENTS AFFECTED BY CHRONIC KIDNEY DISEASES

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfw159.28 ◽

2016 ◽

Vol 31 (suppl_1) ◽

pp. i124-i125

Author(s):

Carlo M. Alfieri ◽

Simone Vettoretti ◽

Roberto Meazza ◽

Valeria Azzini ◽

Lara Caldiroli ◽

...

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Kidney Diseases ◽

Blood Pressure Measurement ◽

Ambulatory Blood Pressure Measurement ◽

Chronic Kidney Diseases

Download Full-text

Hubungan antara Interdialytic Weight Gain dengan Perubahan Tekanan Darah Intradialisis pada Pasien Chronic Kidney Diseases

Jurnal Ilmu Keperawatan Medikal Bedah ◽

10.32584/jikmb.v3i1.320 ◽

2020 ◽

Vol 3 (1) ◽

pp. 32

Author(s):

Ni Kadek Yuni Lestari ◽

Ni Luh Gede Intan Saraswati Saraswati

Keyword(s):

Blood Pressure ◽

Weight Gain ◽

Kidney Diseases ◽

Rank Statistic ◽

P Value ◽

Cross Sectional ◽

Chronic Kidney Diseases ◽

Purposive Sampling ◽

Adherence To Diet ◽

Interdialytic Weight Gain

Pasien CKD (Chronic Kidney Diseases) yang menjalani hemodialisis sering mengalami komplikasi gangguan hemodinamik baik itu hipertensi maupun hipotensi intradialisis. Salah satu penyebab yang paling sering adalah peningkatan IDWG (Interdialytic Weight Gain). Tujuan penelitian ini adalah untuk menganalisis hubungan antara IDWG (Interdialytic Weight Gain)dengan perubahan tekanan darah intradialisis pada pasien CKD di Ruang Hemodialisis RSUP Sanglah Denpasar. Metode penelitian yang digunakan adalah analitik korelasi dengan pendekatan cross sectional. Teknik sampel yang digunakan adalah purposive sampling dengan jumlah sampel sebanyak 80 responden. Analisis statistik dengan menggunakan spearmans rank. Hasil penelitian didapatkan dari 80 responden sebagian besar mempunyai interdialytic weight gain dalam kategori ringan (73,8,0%) dan tekanan darah intradialisis dalam batas normal (65,0%). Hasil uji statistik menunjukkan p value 0,001 (<0,05). Kesimpulan dari penelitian ini bahwa ada hubungan yang signifikan antara interdialytic weight gain dengan perubahan tekanan darah intradialisis pada pasien chronic kidney diseases di Ruang Hemodialisis RSUP Sanglah Denpasar. Berdasarkan hasil penelitian ini bahwa perawat diharapkan dapat meningkatkan pemberian edukasi secara berkala pada pasien hemodialisis reguler untuk meningkatkan kepatuhan pasien pada diet dan pembatasan intake cairan.Chronic Kidney Diseases (CKD) patients who undergo hemodialysis often experience complications of haemodynamic disorders, both hypertension and intradialisis hypotension. One of the most frequent causes of increasing is IDGW (Interdialytic Weight Gain). The purpose of this study was to determine the correlation between interdialytic weight gain and changes in intradialysis blood pressure among patients with chronic kidney diseases in Haemodialysis Roomat Sanglah Hospital Denpasar. The research method used is analytic correlation with cross sectional approach. The sample technique used was purposive sampling with a total sample of 80 respondents. Statistical analysis using spearmans rank statistic test. The results obtained from 80 respondents most mostly interdialytic weight gain in the mild category (73.8.0%) and intradialisis blood pressure within normal limits (65.0%). The result of statistic test shows that p value 0,001 (<0,05). The conclusion of this study is that any significant correlation between interdialytic weight gain with changes in intradialysis blood pressure among patients with CKD at Haemodialysis Room of Sanglah Hospital Denpasar. Suggestions for nurses to increase the provision of regular education in regular haemodialysis patients to improve patient’s adherence to diet and limit fluid intake.

Download Full-text