scholarly journals Biochemical and Chemical Lipid Profile and Blood Pressure Assessment in Arterial Hypertension with Chronic Kidney Disease

2020 ◽  
Vol 71 (7) ◽  
pp. 425-435
Author(s):  
Teim Baaj ◽  
Ahmed Abu-Awwad ◽  
Mircea Botoca ◽  
Octavian Marius Cretu ◽  
Elena Ardeleanu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Lipid Profile ◽  
Blood Pressure Monitoring ◽  
Hdl Cholesterol ◽  
Night Time ◽  
Hypertensive Patients ◽  
Lipid Disorders

Accelerated atherosclerosis and cardiovascular diseases are frequent complications in hypertensive patients with chronic kidney disease (CKD), being mainly driven by cardiovascular risk factors as lipid disorders and an unfavorable blood pressure profile. The objectives of the study were to evaluate the lipid profile and to assess the characteristics of blood pressure (BP) in patients with primary arterial hypertension associating chronic kidney disease (CKD) in a primary care population in Timis County, Romania. Lipid disorders were highly prevalent in hypertensive patients with CKD, consisting in hyper LDL-cholesterolemia in 50.3%, hypertriglyceridemia in 52%, low HDL-cholesterol levels in 35.8%. More than 2 lipid abnormalities were present in 68.8% of CKD hypertensive. CKD hypertensive patients, compared with those without CKD, presented a BP profile with higher systolic and diastolic office BP. On ambulatory blood pressure monitoring they also registred higher systolic and diastolic BP, the systolic BP (SBP), both for 24 h SBP, day-time and night-time SBP being statistically significant higher than in hypertensive patients without CKD. The circadian 24 h BP profile demonstrated in the CKD hypertensive population an unfavourable nocturnal profile in 67%, consisting of a high prevalence of the non-dipping profile and of nocturnal riser pattern.

The Relationship Between Blood Pressure Variability And Renal Progression In Hypertensive Patients With Chronic Kidney Disease

2021 ◽  
Vol 6 (14) ◽  
pp. 80-88
Author(s):  
Huseyin Duru ◽  
Ekrem KARA
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Measurement ◽  
Rapid Progression ◽  
Night Time ◽  
Hypertensive Patients ◽  
Significant Difference ◽  
Renal Progression

Objective: To evaluate the effect of 24 hour systolic blood pressure (SBP) and diastolic blood pressure (DBP) variability (BPV) on renal progression in hypertensive patients with chronic kidney disease (CKD) Methods: A total 59 hypertensive patients (mean age: 54.2±14.6 years, 50.8% male) with CKD who underwent 24 hours ambulatory blood pressure measurement (ABPM) were included. Data on SBP, DBP, BPV coefficients (VC) for SBP (SBP-CV) and DBP (DBP-CV) were recorded. A decrease in e-GFR of <5 ml/min/year was considered as normal renal progression and a decrease in ≥5 ml/min/year was considered as rapid renal progression. Results: Overall, 40.6% of the patients had uncontrolled HT, while 45.8% had non-dipper pattern. Mean±SD daytime and night-time SBP and SBP-VC values were 135.3±17.9 mmHg, 128.6±23.0 mmHg, 11.7±2.8 and 9.5±3.6, respectively. Mean±SD daytime and nigh-time DBP and DBP-VC values were 84.5±13.4 mmHg, 77.2±16.1 mmHg, 13.8±3.8 and 12.0±3.7, respectively. Rapid renal progression was detected in 25.4% of patients with no significant difference in daytime, night-time and total SBP, SBP-VC, DBP and DBP-VC values between patients with rapid vs. natural renal progression. The regression analysis adjusted for age, gender, presence of DM, baseline e-GFR and dipping status revealed no significant impact of SBP-VC and DBP-VC in predicting rapid progression (p> 0.05). Conclusion: In conclusion, our finding revealed no significant association between BPV and renal progression in hypertensive patients with CKD. Larger scale prospective, randomized controlled trials with longer follow-up are needed to clarify this issue.

scholarly journals Ambulatory Arterial Stiffness Index Is Higher in Hypertensive Patients with Chronic Kidney Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ronaldo Altenburg Gismondi ◽  
Mario Fritsch Neves ◽  
Wille Oigman ◽  
Rachel Bregman
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Blood Pressure Monitoring ◽  
Stiffness Index ◽  
Hypertensive Patients ◽  
Clinical Endpoints ◽  
Mdrd Formula ◽  
Arterial Stiffness Index

Ambulatory arterial stiffness index (AASI) is a parameter obtained from ambulatory blood pressure monitoring (ABPM) that correlates with clinical endpoints. The aim of this study was to compare AASI in nondiabetic hypertensive patients with and without chronic kidney disease (CKD). Subjects with systemic arterial hypertension (SAH,n=30) with normal renal function, aged 40 to 75 years, were compared to hypertensive patients with CKD (n=30) presenting estimated glomerular filtration rate (eGFR) <60 mL/min by MDRD formula. ABPM was carried out in all patients. In CKD group, eGFR was 35.3 ± 2.8 ml/min. The mean 24-hour systolic and diastolic blood pressure (BP) was similar in both groups. AASI was significantly higher in CKD group (0.45±0.03versus0.37±0.02,P<0.05), positively correlated to age (r=0.38,P<0.01) and pulse pressure (r=0.43,P<0.01) and negatively correlated to nocturnal BP fall (r=-0.28,P=0.03). These findings indicate the presence of stiffer vessels in CKD hypertensive patients.

RESISTANT ARTERIAL HYPERTENSION IN PATIENTS WITH CHRONIC KIDNEY DISEASE: PREVALENCE, PROGNOSTIC SIGNIFICANCE, REASONS AND APPROACHES TO ANTIHYPERTENSIVE THERAPY

2019 ◽  
Vol 23 (1) ◽  
pp. 37-44 ◽  
Author(s):  
O. B. Kuzmin ◽  
V. V. Zhezha ◽  
L. N. Landar ◽  
O. A. Salova
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Drug Therapy ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Resistant Hypertension ◽  
Antihypertensive Drugs ◽  
Refractory Hypertension ◽  
Hypertensive Patients

Arterial hypertension (AH) resistant to drug therapy is the phenotype of uncontrolled AH, in which patients receiving at least 3 antihypertensive drugs, including a diuretic, maintain blood pressure above the target level. Initially, the term refractory hypertension was also used to refer to resistant hypertension. Recently, however, refractory hypertension has been isolated into a separate phenotype of difficult to treat hypertension, which is defined as insufficient control of target blood pressure, despite the use of at least 5 different mechanisms of antihypertensive drugs, including long-acting diuretic and antagonist of mineralcorticoid receptors. Resistant hypertension is detected in 10–15 % of all hypertensive patients receiving drug therapy, and is often found in patients with chronic kidney disease. Hypertension can be a cause and/or consequence of kidney damage and is typical of most patients with chronic kidney disease. The lack of control of target blood pressure in a significant proportion of hypertensive patients with CKD who receive at least 3 antihypertensive drugs of different mechanisms of action indicates a lack of effectiveness of antihypertensive therapy, which not only accelerates the loss of renal function, but also significantly worsens the prognosis, contributing to such people risk of cardiovascular and renal complications. The review presents data on the prevalence, prognostic value of resistant hypertension in patients with chronic kidney disease, features of its formation and approaches to increasing the effectiveness of antihypertensive therapy in this patient population.

scholarly journals Office Assessed Blood Pressure and Ambulatory Blood Pressure Monitoring in Chronic Kidney Disease Patients Versus Kidney Transplant Recipients

2015 ◽  
Vol 61 (2) ◽  
pp. 91-93
Author(s):  
DI Tarta ◽  
Căldăraru Carmen Denise ◽  
Tarta Cristina ◽  
A Frigy ◽  
E Caraşca ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Kidney Transplant Recipients ◽  
Pressure Monitoring ◽  
Night Time

Abstract How reliable is office assessed blood pressure (BP) in chronic kidney disease (CKD) patients and kidney transplant (KTx) recipients is yet to be determined, although the diagnosis of arterial hypertension has been based on these measurements. The aim of this study was to investigate the potential differences between office assessed BP and ambulatory blood pressure monitoring (ABPM) in CKD patients and KTx recipients. We conducted a prospective study which enrolled 45 patients. Morning and evening seated office BPs were assessed using a sphygmomanometer at 5 consecutive outpatient visits. A mean systolic BP (SBP) and diastolic BP (DBP) was calculated. Ambulatory blood pressure was measured over 24 hours using a Meditech ABPM-05 device. Office SBP was statistically significant higher in CKD patients than KTx recipients both in the morning and evening (p=0.0433 and p=0.0066 respectively). ABPM showed higher night-time SBPs (p=0.0445) and higher overall, day-time and night-time DBPs in KTX recipients (p=0.0001, p=0.0006, p<0.0001 respectively). In CKD patients, office SBPs and DBPs are significantly higher than overall SBPs and DBPs as assessed by 24hr ABPM. Office BP monitoring as assessed by clinician is acceptable but tends to overestimate BP in both CKD and KTx study groups.

Home blood pressure monitoring in hypertensive patients with chronic kidney disease

2015 ◽  
Vol 9 (4) ◽  
pp. e48
Author(s):  
Xiaojing Ye ◽  
Alejandro Negrete ◽  
William N. Davis ◽  
Salman T. Shafi ◽  
Andi M. Negrete ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Hypertensive Patients

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

Hypertension ◽  
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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