scholarly journals Low systolic blood pressure values, renal resistive index measurement and glomerular filtration rate in a non-dialysis dependent chronic kidney disease population

2019 ◽  
Vol 90 (4) ◽  
pp. 288-292
Author(s):  
Simone Brardi ◽  
Gabriele Cevenini
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Systolic Blood Pressure ◽  
Filtration Rate ◽  
Left Kidney ◽  
Resistive Index ◽  
Renal Resistive Index

Objective: A longitudinal prospective case control study was organized to explore the relationships between glomerular filtration rate (GFR), renal resistive index (RRI) and blood pressure values in a non-dialysis dependent adult population affected by chronic kidney disease and exposed to low systolic blood pressure (SBP) values.Material and methods: The study sample (54 patients: 31 males and 23 females with an average age of 61.7 ± 19.2 years) was randomly selected from a population of adult non-dialysis dependent patients that scored a SBP < 100 mmHg at the medical examination. The patients were equally divided in two groups defined by the presence and absence of chronic kidney disease, (i.e. a GFR less or greater than 60 ml/min/1.73 m2, respectively). Patients were submitted to a full therapeutic and dietetic intervention to correct the hypotension until reaching a steady SBP > 100 mmHg. Results: In the group with chronic renal disease, the comparison between the data recorded with SBP < 100 mmHg (t0) and those detected with SBP ≥ 100 mmHg (t1) showed a statistically significant decrease of serum creatinine as well as an increase of GFR (mean serum creatinine t0 – serum creatinine t1: 0.194 ± 0.35, p < 0.01; mean GFR t0 – GFR t1: -4.615 ± 8.8, p < 0.013). There was also a statistically significant reduction of the RRI (mean right kidney RRI t0 – mean right kidney RRI t1: + 0.082 ± 0.03, p < 0; mean left kidney RRI t0 – mean left kidney RRI t1: 0.076 ± 0.03, p < 0). Conclusion: We concluded that, in CKD, when aorta is stiffed, a decrease of SBP can limit the renal perfusion that, in this condition, is mostly dependent by stroke volume, causing an increase of RRI and a decrease of GFR that we suppose as reversible with the restoration of SBP.

scholarly journals Renal resistivity index is inversely proportional to estimated glomerular filtration rate in chronic kidney disease

2018 ◽  
Vol 5 (4) ◽  
pp. 950
Author(s):  
Animesh Gupta ◽  
Piyush Saxena ◽  
Upma Narain ◽  
Seema Pandey ◽  
Poonam Gupta ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Rank Order ◽  
Resistive Index ◽  
Renal Resistive Index ◽  
Resistivity Index

Background: Renal resistive index (RRI) measured by Doppler ultrasonography has been associated with severity, rate of progression and mortality in chronic renal failure. Parameters like renal vascular resistance, filtration fraction and effective renal plasma flow have been associated with renal resistivity index in chronic kidney disease patients.Methods: This hospital based cross-sectional study was conducted from April 2016 to August 2017. 100 patients with chronic kidney disease were enrolled. RRI was calculated from the blood flow velocities observed during Doppler examinations of the segmental arteries and estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Spearman Rank-Order Correlation Coefficient was used.Results: A Significant inverse correlation was observed between RRI and eGFR (r= -0.347, p =0.0004). It was also observed that older age (r= 0.297), higher systolic blood pressure (r= 0.365), lower levels of hemoglobin (r= -0.34 for males and r= -0.353 for females) were observed to correlate with higher values of RRI in advanced CKD stages.Conclusions: RRI correlated inversely with eGFR in chronic kidney disease and hence was directly related to the severity of the disease.

scholarly journals Physical Activity In Renal Disease (PAIRED) and the effect on hypertension: study protocol for a randomized controlled trial

2018 ◽  
Author(s):  
Jeyasundar Radhakrishnan ◽  
MD/ Michelle Graham ◽  
MD Stephanie Thompson ◽  
MMath/PStat Natasha Wiebe ◽  
MD Gabor Gyenes ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Moderate Intensity ◽  
Home Based

Abstract Background: The prevalence of hypertension among people with chronic kidney disease is high with over 60% of people not attaining recommended targets despite multiple medications. Given the health and economic implications of hypertension, additional strategies are needed. Exercise is an effective strategy for reducing blood pressure in the general population; however, it is not known whether exercise would have a comparable benefit in people with moderate to advanced chronic kidney disease and hypertension. Methods: This is a parallel arm trial of adults with hypertension (systolic blood pressure greater than 130 mmHg) and an estimated glomerular filtration rate of 15-45 ml/min 1.73 m2. A total of 160 participants will be randomized, with stratification for estimated glomerular filtration rate, to a 24-week aerobic-based exercise intervention or enhanced usual care. The primary outcome is the difference in 24-hour ambulatory systolic blood pressure after eight weeks of exercise training. Secondary outcomes at eight and 24 weeks include: other measurements of blood pressure, aortic stiffness (pulse wave velocity), change in the Defined Daily Dose of anti-hypertensives, medication adherence, markers of cardiovascular risk, physical fitness (cardiopulmonary exercise testing), seven day accelerometry, quality of life, and adverse events. The effect of exercise on renal function will be evaluated in an exploratory analysis. The intervention is a thrice-weekly moderate intensity aerobic exercise supplemented with isometric resistance exercise delivered in two phases. Phase 1: supervised, facility-based weekly and home-based sessions (eight weeks). Phase 2: home-based sessions (16 weeks). Discussion: To our knowledge, this study is the first trial designed to provide a precise estimate of the effect of exercise on blood-pressure in people with moderate to severe CKD and hypertension. The findings from this study will address a significant knowledge gap in hypertension management in CKD and inform the design of a larger study on the effect of exercise on CKD progression.

RELATIONS OF SERUM TGF-BETA1 LEVELS WITH AGE, SEX, BMI, BLOOD PRESSURE AND GLOMERULAR FILTRATION RATE IN PATIENT WITH CHRONIC KIDNEY DISEASE

2015 ◽  
pp. 138-142
Author(s):  
Van Tuan Nguyen ◽  
Tam Vo ◽  
Bui Bao Hoang ◽  
Thi Phuong Anh Le ◽  
Nguyen Tuong Van Ha
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Glomerular Filtration ◽  
Renal Fibrosis ◽  
Filtration Rate ◽  
Men And Women ◽  
Pressure Index

Renal fibrosis is the main cause leading to end-stage chronic kidney disease. Transforming growth factor - beta 1 (TGF-beta1) have a major role in the process of renal fibrosis. Objectives: To survey the relation of serum TGF beta1 level with: age, sex, BMI, blood pressure and glomerular filtration rate. Method: A cross-sectional study. Results: Levels of serum TGF-beta1; in patients <40 year old, 40-60 year old and > 60 year of age were respectively 39,97 ± 9,76 ng / ml; 36,07 ± 10,10 ng / ml and 38,29 ± 10,87 ng / ml, p> 0,05. In men and women were respectively 36,71 ± 9,12 ng / ml and 40,43 ± 10,54, p> 0,05. In patient group with BMI ≤ 23 and > 23 were respectively 37,95 ± 9,85 ng / ml and 37,58 ± 12,38, p > 0,05. Levels of serum TGF-beta1 positive correlated with systolic blood pressure index (r = 0,40; p < 0,01) and negative correlated with glomerular filtration rate (r = - 0,29; p <0,01). Conclusion: There are no difference of serum TGF-beta1 levels between men and women, between the age groups (<40 years, 40 to < 60 years and ≥ 60 years), between BMI groups < 23 and BMI group ≥ 23. Level of serum TGF-beta1 positive correlated with systolic blood pressure index and negative correlated with glomerular filtration.vKey words: TGF-beta1, chronic kidney disease

scholarly journals Physical Activity In Renal Disease (PAIRED) and the effect on hypertension: study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
MD Stephanie Thompson ◽  
MMath/PStat Natasha Wiebe ◽  
MD Gabor Gyenes ◽  
MSc Rachelle Davies ◽  
Jeyasundar Radhakrishnan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Moderate Intensity ◽  
Home Based

Abstract Background: The prevalence of hypertension among people with chronic kidney disease is high with over 60% of people not attaining recommended targets despite multiple medications. Given the health and economic implications of hypertension, additional strategies are needed. Exercise is an effective strategy for reducing blood pressure in the general population; however, it is not known whether exercise would have a comparable benefit in people with moderate to advanced chronic kidney disease and hypertension. Methods: This is a parallel arm trial of adults with hypertension (systolic blood pressure greater than 130 mmHg) and an estimated glomerular filtration rate of 15-45 ml/min 1.73 m2. A total of 160 participants will be randomized, with stratification for estimated glomerular filtration rate, to a 24-week aerobic-based exercise intervention or enhanced usual care. The primary outcome is the difference in 24-hour ambulatory systolic blood pressure after eight weeks of exercise training. Secondary outcomes at eight and 24 weeks include: other measurements of blood pressure, aortic stiffness (pulse wave velocity), change in the Defined Daily Dose of anti-hypertensives, medication adherence, markers of cardiovascular risk, physical fitness (cardiopulmonary exercise testing), seven day accelerometry, quality of life, and adverse events. The effect of exercise on renal function will be evaluated in an exploratory analysis. The intervention is a thrice-weekly moderate intensity aerobic exercise supplemented with isometric resistance exercise delivered in two phases. Phase 1: supervised, facility-based weekly and home-based sessions (eight weeks). Phase 2: home-based sessions (16 weeks). Discussion: To our knowledge, this study is the first trial designed to provide a precise estimate of the effect of exercise on blood-pressure in people with moderate to severe CKD and hypertension. The findings from this study will address a significant knowledge gap in hypertension management in CKD and inform the design of a larger study on the effect of exercise on CKD progression. Trial registration: Registered at ClinicalTrials.gov NCT03551119. Registered on 11 June 2018.

scholarly journals Effect of Atorvastatin and Losartan on Glomerular Filtration Rate in Patients With Mild to Moderate Chronic Kidney Disease

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 43-47
Author(s):  
Md Moniruzzaman Khan ◽  
Zesmin Fauzia Dewan ◽  
AKM Shahidur Rahman ◽  
Bakhtiare Md Shoeb Nomany ◽  
Ahmed Salam Mir ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Diseases ◽  
Cell Damage ◽  
Renoprotective Effect ◽  
Ckd Stage

Background: Atorvastatin, a member of HMG CO-A reductase inhibitors, has been shown to have renoprotective effect in patients with Chronic Kidney Disease (CKD). Statins are supposed to decrease the oxidized lipid particles, suppress the activity of inflammatory mediators and prevent vascular thrombosis and thus could minimize renal cell damage. Losartan, an antihypertensive drug also diminishes proteinuria in patients with chronic kidney diseases or diabetes mellitus. Therefore the effect of concurrent use of atorvastatin and losartan on Glomerular Filtration Rate (GFR) could be a matter of interest from both Pharmacological and Clinical perspective. Objective: To assess the renoprotective effect of atorvastatin and losartan in patients with chronic kidney disease treated at Bangabandhu Sheikh Mujib Medical University (BSMMU). Materials and Method: Total forty four (44) patients suffering from CKD (stage one to stage three) were enrolled into two groups. Patients in Group A, received atorvastatin (10 mg) and losartan (50 mg) once daily for eight weeks. Patients in Group B, received losartan but not atorvastatin for the same duration. Serum creatinine level was measured at the commencement and also after eight weeks to calculate estimated glomerular filtration rate (eGFR) in individual patients with MDRD (Modification of Diet in Renal Disease) study equation. Results: There was significant (P < 0.001) reduction of Serum Creatinine and significant (P < 0.001) increase in e GFR in the patients, treated with atorvastatin and losartan. Conclusion: Concurrent administration of atorvastatin and losartan increased glomerular filtration rate (GFR) significantly in patients with chronic kidney disease. KYAMC Journal Vol. 10, No.-1, April 2019, Page 43-47

Abstract 066: Association Between Nocturnal Blood Pressure Dipping Magnitude And Chronic Kidney Disease Risk Among Patients With Controlled Office Blood Pressure

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
So Mi J Cho ◽  
Hokyou Lee ◽  
Tae-Hyun Yoo ◽  
Jong Hyun Jhee ◽  
Sungha Park ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Lower Risk ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Disease Risk ◽  
Chronic Kidney Disease Risk

Although abnormal diurnal blood pressure (BP) patterns are associated with adverse cardiorenal outcomes, their risks are yet unquantified by BP dipping magnitude. We assessed chronic kidney disease risk across nocturnal BP dipping spectrum among patients with controlled hypertension without prior advanced kidney disease. Ambulatory BP measurements were collected from 995 middle-aged patients with controlled office BP (<140/90 mmHg). The magnitude of dipping was defined as the difference between daytime and nighttime systolic BP divided by daytime systolic BP. Accordingly, patients were categorized as extreme-dipper (≥20%) dipper (10-<20%), non-dipper (0-<10%), or reverse-dipper (<0%). We cross-sectionally analyzed continuous and categorical associations of dipping with albuminuria (urine albumin-to-creatinine ratio ≥30 mg/g) and decreased estimated glomerular filtration rate (<60 ml/min/1.73m 2 ), adjusting for office/ambulatory BP, antihypertensive class, body mass index, total cholesterol, fasting glucose, socioeconomic status, and health behavior. The participants (mean age 60.2 years; 52.9% male) consisted of 13.5% (134 of 995) extreme-dippers, 43.1% (429 of 995) dippers, 34.7% (345 of 995) non-dippers, and 8.7% (87 of 995) reverse-dippers. In reference to dippers, odds ratios (95% confidence interval) for albuminuria were 1.73 (1.04-2.60) in reverse-dippers, 1.67 (1.20-2.32) in non-dippers, and 0.62 (0.38-1.04) in extreme-dippers; this reflects significantly lower risk (0.77, 0.55-0.95) per 10% dipping. Likewise, persons presenting reduced and reverse-directional dipping were at higher risk for decreased estimated glomerular filtration rate: reverse-dippers 2.02 (1.06-3.84); non-dippers 1.98 (1.07-3.08); extreme-dippers 0.69 (0.20-1.17), with lower risk (0.74, 0.22-1.02) per every 10%. In short, monitoring nocturnal BP patterns may identify chronic kidney disease risk otherwise overlooked based on office BP.

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