scholarly journals Comparative assessment of renal function by cystatin C level in patients with hypertension and extrasystole

Author(s):  
A. V. Ivankova ◽  
N. V. Kuzminova ◽  
S. E. Lozinsky ◽  
V. P. Ivanov

Although the tight connection of the cardiovascular system and the kidneys is well known, using of cystatin C (Cys-C) opens new horizons in studying early renal failure stages. The study aimed to compare the functional status of the kidneys in patients with hypertension and extrasystole to the level of Cys-C. 156 patients with stage II hypertension (EH II) were examined. 124 of them had frequent symptomatic extrasystoles (74 – of supraventricular origin and 50 – ventricular), 32 patients had no arrhythmias, and were referred to the comparison group. The control group consisted of 30 healthy people with normal blood pressure (BP). All patients underwent a complete clinical examination, blood pressure measurement, daily blood pressure monitoring, daily electrocardiogram monitoring, echocardiography, and determination of renal function (creatinine, blood electrolytes, serum cystatin C) followed by calculation of glomerular filtration rate (GFR). The level of Cys-C in patients with hypertension was significantly higher (p<0.001) compared with healthy individuals. Among patients with arrhythmias, the highest level of Cys-C was noted in patients with ventricular arrhythmias. The correlation analysis showed that the level of Cys-C was higher in the presence of frequent extrasystoles (namely of ventricular origin), smoking, high blood pressure, increased systolic and pulse blood pressure, the presence of concentric left ventricular hypertrophy, dyslipidemia, increased creatinine level and decreased GFR. All three EH II patient groups had significantly lower GFR (calculated by creatinine level) (p<0.001). The lowest creatinine-based GFR was revealed in patients with ventricular extrasystole. All patients with EH II had significantly lower Cys-C based GFR than the control group (p<0.001). Mean Cys-C-based GFR values in patients with extrasystole were significantly lower than in patients without extrasystole (p<0.03). The analysis of GFR levels depending on the extrasystole origin was provided. The lowest level of GFR was recorded in patients with ventricular extrasystole. It was significantly different from the patients with supraventricular extrasystole (p=0.02). Our findings confirm the opinion of other researchers that Cys-C is an early marker of renal dysfunction in patients with hypertension, which is more sensitive than creatinine. Another finding is that ventricular extrasystole is more hemodynamically and metabolically unfavorable compared to supraventricular based on clinical and prognostic evaluation.

2016 ◽  
Vol 13 (4) ◽  
pp. 60-65
Author(s):  
N V Blinova ◽  
Yu V Zhernakova ◽  
I E Chazova ◽  
E V Oshchepkova

Aims: to study the target organ damage in patients with metabolic syndrome (MS) and arterial hypertension (AH) 1 degree. Design and methods. We included 20 healthy volunteers and 60 patients with MS, AH 1 degree and dyslipidemia. Office blood pressure, 24-hour ambulatory blood pressure monitoring, measurements of the endothelial vasoactive mediators, carotid ultrasonography and echocardiography had performed at baseline. Results. The majority of patients with MS and AH 1 degree had metabolic abnormalities; the levels of vasoactive mediators were higher in comparison with control group; 30% of patients had signs of atherosclerotic process in carotid arteries; 40% of patients had left ventricular hypertrophy. Conclusion: the results showed high prevalence of target organ damage in patients with MS and AH 1 degree.


2019 ◽  
Vol 47 (10) ◽  
pp. 4958-4967
Author(s):  
J Sveceny ◽  
J Charvat ◽  
K Hrach ◽  
M Horackova ◽  
O Schück

Objectives To evaluate the association between diastolic blood pressure (BP), measured by 24-hour ambulatory blood pressure monitoring (ABPM) and renal function in patients receiving treatment for essential hypertension. Methods In this cross-sectional study, ABPM, transthoracic echocardiography, estimated glomerular filtration rate (eGFR) on the basis of serum cystatin C (eGFRcyst) and the renal resistive index (RRI) were measured in patients with essential hypertension. Results The cohort consisted of 105 patients (39 men, 66 women), with a mean ± SD age of 58 ± 12 years who had been receiving treatment for 11 ± 8 years. 24-hour diastolic BP significantly positively correlated with eGFRcyst and negatively correlated with RRI. No correlation was observed with 24-hour systolic BP values. 24-hour diastolic BP values ≤70 mmHg were associated with eGFRcyst ≤60 ml/min/1.73 m2 (i.e., decreased GFR). Conclusion 24-hour diastolic BP values were significantly associated with markers of kidney function in patients receiving treatment for essential hypertension and values ≤70 mmHg may be associated with subnormal eGFRcyst.


Author(s):  
Tamara Haiduk ◽  
Olha Haiduk ◽  
Irene Gubar

Abstract: Objective: To investigate the significance of 24-hr ambulatory blood pressure monitoring (ABPM) data and metabolism indicators, as well their correlation in predicting the risk of left ventricular hypertrophy (LVH) in children and adolescents with arterial hypertension (AH). Methods: We studied 118 children and adolescents, M±m 15.51±0.25 yrs, Boys/Girls – 104/14, with AH: 60 stable, 40 labile, 18 prehypertension (high-normal blood pressure), and a control group of 13 normotensive children, M±m 15,19±0,41 yrs, Boys/Girls – 10/3. All patients underwent a comprehensive anamnestic, clinical, laboratory, and instrumental examination, including 24-hr ABPM; indicators were standardized by gender and age. On Doppler echocardiography (echoCG), the left ventricular myocardial mass index (LVMI) was calculated. Lipid spectrum parameters were determined by biochemical method, venous blood glycemia by GOD-PAP, blood serum basal immunoreactive insulin by ELISA methods, insulin resistance (IR) by HOMA parameters calculation. Statistical processing was performed using the package of statistical analysis software STATISTICA. Results: Of a range of metabolism indicators, BMI, TG level, LDL/HDL ratio, HOMA index, 24-hr DBP index, and the stable character of AH identified as the most significant factors in predicting the risk of LVH in hypertensive children. All multivariate models of logistic regressions, which include BMI, can predict the probability of LVH with an accuracy of 79.7-84.7%, sensitivity - 57.5-77.5%, specificity - 86.4-91.0%. Conclusions: Obtained satisfactory concordance of the actual data with predictive models' results indicate the possibility of their use to predict the risk of LVH in children and adolescents with AH.


2020 ◽  
Vol 10 (8) ◽  
pp. 1809-1814
Author(s):  
Jun Xie ◽  
Zeping Hu ◽  
Yuanyuan Sun ◽  
Linlin Yang

To explore the correlation between frailty score and renal function impairment of elderly patients with hypertension. A total of 124 patients admitted to the Hefei Hospital Affiliated to Anhui Medical University/Hefei Second People’s Hospital between October 2017 and January 2019 with hypertension complicated with frailty were included. Patients with hypertension were divided into the Observation Group and Control Group (62 patients each). The blood pressure variability rate, renal function, and frailty score were compared between the two groups. Furthermore, the correlation between frailty score and renal function index was analyzed. The variations in the 24-h systolic and 24-h diastolic blood pressure in the Observation Group were significantly higher than those in the Control Group (P < 0.05). Levels of cystatin C, homocysteine, urea nitrogen, creatinine, and uric acid were all higher in the Observation Group than in the Control Group, with the difference being statistically significant (P < 0.05). Meanwhile, no statistical difference was observed between urea nitrogen/creatinine and hypersensitive CRP (P > 0.05). Pearson partial correlation analyses showed that the weakness score was positively correlated with systolic pressure variation percentage, diastolic pressure variation percentage, homocysteine, cystatin C, creatinine, and urea nitrogen (P < 0.05). The scores of various dimensions of weakness obtained via further regression analyses showed that the scores of physical frailties were positively correlated with homocysteine and cystatin C (P < 0.05). Multivariate analysis showed that frailty score, percentage of diastolic blood pressure variation, and physical weakness were independent factors affecting cystatin C level (P < 0.05). The rate of blood pressure variability is higher and renal function damage is more common in elderly hypertension patients with frailty. Frailty score, percentage of diastolic pressure variation, and physical weakness were independent risk factors affecting renal function.


2019 ◽  
Vol 10 (01) ◽  
pp. 33-44
Author(s):  
N.L.G. Sudaryati ◽  
I P. Sudiartawan ◽  
Dwi Mertha Adnyana

The aim of the study was to determine the effectiveness of giving hydrotherapi foot soak in hypertensive patients. The study was conducted with one group pretestposttest design without a control group by measuring blood pressure (pretest) before being given an intervention in the form of foot soak hydrotherm against 15 people with hypertension in Banjar Sri Mandala, Dauhwaru Village, Jembrana Subregency. Then do the blood pressure measurement again (posttest) after finishing the intervention. After the study was completed, the results showed that before the hydrotherapi foot bath intervention, there were 0% of patients classified as normal, 13.32% in prehypertension category, 60.08% in hypertension category I and 26.60% in hypertension category II. After the intervention was given, there were 13.32% of the patients classified as normal, 66.68% in the prehypertension category, 20.00% in the first category of hypertension and no patients belonging to the second grade hypertension category. There is a decrease of 20-30 mmHg for systolic blood pressure and 0-10 mmHg for diastolic blood pressure after intervention. Based on the results of the study it can be concluded that the hydrotherapi foot bath is effectively used to reduce blood pressure in hypertensive patients in the Banjar Sri Mandala, Dauhwaru Village, Jembrana District.


2019 ◽  
Vol 2 (3) ◽  
pp. 206-214
Author(s):  
Putri Indes Oktabriani ◽  
Fuad Ughi ◽  
Aulia Arif Iskandar

The continuous blood pressure measurement research is widely known for helpingthe development of ambulatory blood pressure monitoring where it measures blood pressureevery 15 to 30 minutes throughout the day. The cuff is a problem for the patient withAmbulatory Blood Pressure Monitor. It can make a person feel uncomfortable and must staystill when the cuff starts to inflate. It is limiting and disturbing their daily activity when thedevice is starting to measure the blood pressure. Blood pressure measurement without cuff isbeing proposed in this research, called cuff-less blood pressure measurement. It will be based onPhotoplethysmography (PPG) and Electrocardiography (ECG) signal analysis. ECG (Lead 1,Lead 2, and Lead 3) with PPG signal produced from index finger on the left hand are comparedand analyzed. Then the relation of PPG and ECG signal and the optimum location for daily usecan be obtained. The optimum location will be based on the electrode’s position that producedthe optimum ECG lead Signal to measure blood pressure. Based on the result, PPG and ECGsignal have a linear relation with Blood Pressure Measurement and Lead 1 is more stable inproducing the ECG signal. The equation from Lead 1 appeared as one of the optimum equationsfor measuring Systolic Blood Pressure (SBP) or Diastolic Blood Pressure (DBP).


Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 100
Author(s):  
Asmaa A. Mahmoud ◽  
Doaa M. Elian ◽  
Nahla MS. Abd El Hady ◽  
Heba M. Abdallah ◽  
Shimaa Abdelsattar ◽  
...  

Background: A good survival rate among patients with beta thalassemia major (beta-TM) has led to the appearance of an unrecognized renal disease. Therefore, we aimed to assess the role of serum cystatin-C as a promising marker for the detection of renal glomerular dysfunction and N-acetyl beta-D-glucosaminidase (NAG) and kidney injury molecule 1 (KIM-1) as potential markers for the detection of renal tubular injury in beta-TM children. Methods: This case-control study was implemented on 100 beta-TM children receiving regular blood transfusions and undergoing iron chelation therapy and 100 healthy children as a control group. Detailed histories of complete physical and clinical examinations were recorded. All subjected children underwent blood and urinary investigations. Results: There was a significant increase in serum cystatin-C (p < 0.001) and a significant decrease in eGFR in patients with beta-TM compared with controls (p = 0.01). There was a significant increase in urinary NAG, KIM-1, UNAG/Cr, and UKIM-1/Cr (p < 0.001) among thalassemic children, with a significant positive correlation between serum cystatin-C, NAG and KIM-1 as regards serum ferritin, creatinine, and urea among thalassemic patients. A negative correlation between serum cystatin-C and urinary markers with eGFR was noted. Conclusion: Serum cystatin-C is a good marker for detection of glomerular dysfunction. NAG and KIM-1 may have a predictive role in the detection of kidney injury in beta-TM children.


2016 ◽  
Vol 11 ◽  
pp. BMI.S39199 ◽  
Author(s):  
Habib Mawad ◽  
Louis-Philippe Laurin ◽  
Jean-François Naud ◽  
François A. Leblond ◽  
Nathalie Henley ◽  
...  

Objective The aim of our study is to describe the changes in urinary and serum levels of novel biomarkers after gadolinium contrast administration in patients with normal renal function. Methods We measured four biomarkers in 28 volunteers: interleukin-18 (IL-18), N-acetyl-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin, and cystatin C. Urinary and serum samples were collected at 0, 3, and 24 hours following gadolinium administration. Results Baseline serum creatinine was 57.8 ± 34.5 μmol/L and remained stable. Urinary IL-18 levels increased significantly at three hours (10.7 vs. 7.3 ng/mg creatinine; P < 0.05). Similarly, urinary NAG levels increased significantly at three hours (3.9 vs. 2.2 IU/mg creatinine; P < 0.001). For both these markers, the difference was no longer significant at 24 hours. No statistically significant differences were observed for urinary and serum neutrophil gelatinase-associated lipocalin levels and for serum cystatin C levels. Conclusions Urinary IL-18 and NAG levels increased transiently after administration of gadolinium-based contrast agents in patients with normal renal function.


2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110161
Author(s):  
Zhenhong Zhang ◽  
Shunyin Wang ◽  
Junru Yan ◽  
Zhiwen Xu ◽  
Dongliang Liang ◽  
...  

Objective We assessed differences and correlations between 24-hour ambulatory blood pressure (ABP) and office blood pressure (OBP) monitoring. Methods We conducted an observational study among 85 untreated patients with essential hypertension and measured 24-hour ABP, OBP, target organ damage (TOD) markers, and metabolism indexes. Variance analysis and the Pearson method were used to compare differences and correlation between the two methods. The Spearman or Pearson method was applied to compare the correlation between TOD markers, blood pressure index, and metabolism index. Linear regression analysis was applied to estimate the quantitative relationship between the blood pressure index and TOD markers. Results There were significant differences in the mean and variance of systolic blood pressure (SBP) and diastolic blood pressure and a positive correlation between ABP and OBP. Correlations between the left ventricular mass index (LVMI) and average ambulatory SBP, daytime ambulatory SBP, nighttime ambulatory SBP, and fasting blood glucose were significant. Correlations between left intima-media thickness (IMT) and average ambulatory SBP, nighttime ambulatory SBP, right IMT, and nighttime ambulatory SBP were significant. In linear regression analysis of the LVMI (y) and ambulatory SBP (x), the equation was expressed as y = 0.637*x. Conclusion Nighttime ambulatory SBP may be an optimal predictor of TOD.


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