Hemodynamic Correlates of Proteinuria in Chronic Kidney Disease
Autor: | Jiang He, Valerie Teal, Jeffrey C. Fink, Stephen M. Sozio, Jing Chen, Lawrence J. Appel, Marshall M. Joffe, Matthew R. Weir, Susan Steigerwalt, Natasha Litbarg, Louise Strauss, Cheryl A.M. Anderson, Leigh K. Rosen, Mahboob Rahman, Raymond R. Townsend, Akinlolu O. Ojo |
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Rok vydání: | 2011 |
Předmět: |
Male
medicine.medical_specialty Brachial Artery Epidemiology Renal function Hemodynamics Blood Pressure urologic and male genital diseases Critical Care and Intensive Care Medicine Risk Assessment Cohort Studies Risk Factors medicine.artery Internal medicine Humans Medicine Diabetic Nephropathies cardiovascular diseases Brachial artery Pulse wave velocity Aorta Aged Transplantation Proteinuria business.industry Original Articles Middle Aged medicine.disease United States female genital diseases and pregnancy complications Pulse pressure Cross-Sectional Studies Endocrinology Blood pressure Nephrology Pulsatile Flow Chronic Disease Multivariate Analysis Cardiology Regression Analysis Female Kidney Diseases medicine.symptom business circulatory and respiratory physiology Kidney disease |
Zdroj: | Clinical Journal of the American Society of Nephrology. 6:2403-2410 |
ISSN: | 1555-9041 |
Popis: | Brachial artery measures of BP are associated with increasing degrees of proteinuria. Whether central measures of BP or vascular stiffness are associated with increased risk of proteinuria in patients with chronic kidney disease (CKD) is unknown.Measurements of central and brachial artery BP, and aortic pulse wave velocity (PWV) were performed in a cross-sectional cohort of patients with CKD (n = 2144) from the Chronic Renal Insufficiency Cohort (CRIC) study to determine factors which predict increased risk of proteinuria. Multivariate analysis stratified by diabetes included age, ethnicity, gender, estimated glomerular filtration rate (GFR), waistline, smoking, heart rate, and medications to evaluate the relationship of hemodynamic factors and proteinuria.Brachial artery systolic BP (SBP) was important as an explanatory factor for variations in proteinuria among both diabetics (R(2) = 0.40, P0.0001) and non diabetics (R(2) = 0.38, P0.001). Measures of peripheral pulse pressure (PP), central SBP, and central pulse pressure added little to the explained variation in proteinuria beyond brachial artery SBP, whereas PWV as a measure of vascular stiffness incrementally accounted for a significant portion of variation in proteinuria beyond that explained by brachial artery SBP in diabetics (R(2) = 0.42, P0.001) but not non diabetics.Brachial artery SBP and PWV are both associated with variations in proteinuria in patients with CKD. |
Databáze: | OpenAIRE |
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