scholarly journals Clinicopathologic Features and Risk Factors of Proteinuria in Transplant Glomerulopathy

2021 ◽  
Vol 8 ◽  
Author(s):  
Qiang Zhang ◽  
Klemens Budde ◽  
Danilo Schmidt ◽  
Fabian Halleck ◽  
Michael Duerr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Calcium Channel ◽  
Diastolic Blood Pressure ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Multivariable Logistic Regression Analysis ◽  
Transplant Glomerulopathy ◽  
C4d Staining

Background: Transplant glomerulopathy (TG) is one of the main causes of post-transplant proteinuria (PU). The features and possible risk factors for proteinuria in TG patients are uncertain.Methods: We investigated all patients who had biopsy-proven TG from 2000 to 2018 in our center. The clinical and histological data were compared between two groups with or without PU (cut-off = 0.3 g/day). Spearman correlation analysis was used to evaluate the relationship between PU and pathological changes. The risk factors for PU in TG patients were determined by multivariable logistic regression analysis.Results: One hundred and twenty-five (75.76%) of all enrolled 165 TG patients had proteinuria ≥0.3 g/day at the time of biopsy. TG patients' PU level was significantly correlated with Banff lesion score cg (ρ = 0.247, P = 0.003), and mm (ρ = 0.257, P = 0.012). Systolic blood pressure ≥140 mmHg (OR 2.72, 95% CI 1.04–7.10, P = 0.041), diastolic blood pressure ≥90 mmHg (OR 4.84, 95% CI 1.39–16.82, P = 0.013), peak PRA ≥5% (OR 6.47, 95% CI 1.67–25.01, P = 0.007), positive C4d staining (OR 4.55, 95% CI 1.29–16.11, 0.019), tacrolimus-based regimen (OR 3.5, 95% CI 1.28–9.54, P = 0.014), and calcium channel blocker usage (OR 4.38, 95% CI 1.59–12.09, P = 0.004) were independent risk factors for PU.Conclusions: Proteinuria is common in TG patients. systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, peak PRA ≥5%, positive C4d staining, tacrolimus-based regimen, and calcium channel blocker usage are associated with proteinuria in TG patients.

Effects of an Antihypertensive Combination in Japanese Hypertensive Outpatients Based on the Long-Acting Calcium Channel Blocker Benidipine on Vascular and Renal Events: A Sub-Analysis of the COPE Trial

2020 ◽  
Vol 16 ◽  
Author(s):  
Seiji Umemoto ◽  
Toshio Ogihara ◽  
Masunori Matsuzaki ◽  
Hiromi Rakugi ◽  
Kazuyuki Shimada ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Rank Test ◽  
Vascular Events ◽  
Treatment Groups ◽  
Β Blocker ◽  
The Difference ◽  
Long Acting

Background: In the trial known as COPE (Combination Therapy of Hypertension to Prevent Cardiovascular Events) three benidipine (a calcium channel blocker; CCB) regimens were compared. Hypertensive Japanese outpatients aged 40–85 years (n=3,293) who did not achieve the target blood pressure of <140/90 mmHg with benidipine 4 mg/day were treated with the diuretic thiazide (n=1,094) or a β-blocker (n=1,089) or an additional angiotensin receptor blocker (ARB; n=1,110). A significantly higher incidence of hard cardiovascular composite endpoints and of fatal or non-fatal strokes was observed in the benidipine-β-blocker group compared to the benidipine-thiazide group. Objective and Methods: We further evaluated the treatment effects of the three benidipine-based regimens on vascular and renal events in a sub-analysis of the COPE patients. Results: A total of 10 vascular events (0.8 per 1,000 person-years) including one aortic dissection (0.1 per 1,000 person-years) and nine cases of peripheral artery disease (0.8 per 1,000 person-years) were documented, as was a total of seven renal events (0.6 per 1,000 person-years). No significant differences in vascular and renal events were revealed among the three treatment groups: vascular events p=0.92 renal events p=0.16 log-rank test. Conclusions: Blood pressure-lowering therapy with benidipine combined with an ARB, β-blocker, or thiazide was similarly effective in the prevention of vascular and renal events in hypertensive outpatients, although there is no enough these events to compare the difference in the three treatment groups.

scholarly journals Waist circumference, body mass index, and skinfold thickness as potential risk factors for high blood pressure in adolescents

2019 ◽  
Vol 59 (2) ◽  
pp. 79-86
Author(s):  
Roslina Dewi ◽  
Rafita Ramayati ◽  
Nelly Rosdiana ◽  
Oke Rina Ramayani ◽  
Rosmayanti Siregar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Potential Risk ◽  
Predictive Factor ◽  
Skinfold Thickness ◽  
Potential Risk Factors

Background The prevalence of hypertension in children and adolescents has increased with the rising obesity epidemic. Recent studies have found that prevalence of hypertension was higher in obese children or adolescents than in the normal weight ones. Anthropometric measurements such as body mass index (BMI), waist circumference, and skinfold thickness have been used as criteria to determine obesity in children and adolescents. Increased waist circumference has been most closely related to increased blood pressure. Objective To compare waist circumference, BMI, and skinfold thickness as potential risk factors for hypertension in adolescents. Methods This cross-sectional study was conducted in May 2014 in three senior high schools in Medan, North Sumatera, and included 253 students with normal urinalysis test. All subjects underwent blood pressure, waist circumference, tricep- and subscapular-skinfold thickness (TST and SST), body weight, and body height measurements. The study population was categorized into underweight, normoweight, overweight, and obese, according to four different criteria: waist circumference, BMI, TST, and SST; all variables were analyzed for possible correlations with systolic and diastolic blood pressure. Results There were significant positive correlations between systolic blood pressure and waist circumference (OR 7.933; 95%CI 2.20 to 28.65; P=0.011) as well as BMI (OR 4.137; 95%CI 1.16 to 14.75; P=0.041). There were also significant correlations between diastolic blood pressure and waist circumference (OR 3.17; 95%CI 1.83 to 5.51; P=0.002), BMI (P=0.0001; OR=3.69), TST (OR 4.73; 95%CI 2.31 to 9.69; P=0.0001), and SST (OR 3.74; 95%CI 2.35 to 5.94; P=0.0001). Multivariate analysis showed that waist circumference was a predictive factor for systolic blood pressure (OR 9.667), but not for diastolic blood pressure. Conclusion Waist circumference is the strongest, significant, predictive factor for elevated systolic blood pressure; meanwhile BMI, SST, and TST could be predictive factors for elevated diastolic blood pressure. 

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