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Annual deterioration of renal function in hypertensive patients with and without diabetes
Chronic kidney disease (CKD) complicates hypertension and diabetes. Knowledge of the deterioration rate of CKD may anticipate adjustment of therapies with renal elimination. This study evaluates the rate of annual deterioration of renal function in hypertensive patients either with type 2 diabetes (...
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| Published in: | Vascular health and risk management 2017-01, Vol.13, p.231-237 |
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| creator | Polonia, Jorge Azevedo, André Monte, Miguel Silva, José A Bertoquini, Susana |
| description | Chronic kidney disease (CKD) complicates hypertension and diabetes. Knowledge of the deterioration rate of CKD may anticipate adjustment of therapies with renal elimination. This study evaluates the rate of annual deterioration of renal function in hypertensive patients either with type 2 diabetes (DM2) or without it (non-DM) followed for 5 years and relates it with blood pressure (BP) and glycemic control.
Out of a total of 1924 patients, 1023 patients (594 non-DM and 429 DM2, 53% female, aged 62.1±10.2 years) were evaluated over 5 years for the annual evolution of renal function (estimated glomerular filtration rate [eGFR], Modification of Diet in Renal Disease) ambulatory 24-hour blood pressure and metabolic parameters, corresponding to the analysis of 2378 patient-years.
DM2 and non-DM did not differ for age, mean 24-hour BP levels, nighttime BP, albuminuria, and body mass index. DM2 versus non-DM showed a higher ( |
| doi_str_mv | 10.2147/VHRM.S135253 |
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| fullrecord | <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_acbe922a477443ab8def2dcaf5cf9ad6</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A535420905</galeid><doaj_id>oai_doaj_org_article_acbe922a477443ab8def2dcaf5cf9ad6</doaj_id><sourcerecordid>A535420905</sourcerecordid><originalsourceid>FETCH-LOGICAL-c576t-e0ee3858d96716b5e213d98791c3ec7923aed0a6f345b4e03c27664c3b8b62d33</originalsourceid><addsrcrecordid>eNptkluLEzEUgAdR3Iu--SwDguyDrblOkhehLOourAjewKeQSc60KdOkm8ys7L83vbi2IiEknHznCzk5VfUCoynBTLz9cfXl0_Qrppxw-qg6xVjICUFMPj7Yn1RnOS8R4o1E-Gl1QqQgGDX0tPo5C2E0fe1ggORjMoOPoY5dnSCUcDcGu434UC_u15AGCNnfQb0uIIQh17_8sKhNcNtNHIfaedMWWX5WPelMn-H5fj2vvn94_-3yanLz-eP15exmYrlohgkgACq5dKoRuGk5EEydkkJhS8EKRagBh0zTUcZbBohaIpqGWdrKtiGO0vPqeud10Sz1OvmVSfc6Gq-3gZjm2qTB2x60sS0oQgwTgjFqWumgI86ajttOGdcU17udaz22K3C2vDCZ_kh6fBL8Qs_jneZMSY5YEVzsBSnejpAHvfLZQt-bAHHMGiuCaJlKFPTVP-gyjqkUPWtCiBJYUcL-UnNTHuBDF8u9diPVM045KyrECzX9D1WGg5W3MUDnS_wo4fVBwgJMPyxy7MfNX-dj8M0OtCnmnKB7KAZGetN_etN_et9_BX95WMAH-E_D0d_SItVF</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2229719324</pqid></control><display><type>article</type><title>Annual deterioration of renal function in hypertensive patients with and without diabetes</title><source>Taylor & Francis_OA刊</source><source>Publicly Available Content Database</source><source>PubMed Central</source><creator>Polonia, Jorge ; Azevedo, André ; Monte, Miguel ; Silva, José A ; Bertoquini, Susana</creator><creatorcontrib>Polonia, Jorge ; Azevedo, André ; Monte, Miguel ; Silva, José A ; Bertoquini, Susana</creatorcontrib><description>Chronic kidney disease (CKD) complicates hypertension and diabetes. Knowledge of the deterioration rate of CKD may anticipate adjustment of therapies with renal elimination. This study evaluates the rate of annual deterioration of renal function in hypertensive patients either with type 2 diabetes (DM2) or without it (non-DM) followed for 5 years and relates it with blood pressure (BP) and glycemic control.
Out of a total of 1924 patients, 1023 patients (594 non-DM and 429 DM2, 53% female, aged 62.1±10.2 years) were evaluated over 5 years for the annual evolution of renal function (estimated glomerular filtration rate [eGFR], Modification of Diet in Renal Disease) ambulatory 24-hour blood pressure and metabolic parameters, corresponding to the analysis of 2378 patient-years.
DM2 and non-DM did not differ for age, mean 24-hour BP levels, nighttime BP, albuminuria, and body mass index. DM2 versus non-DM showed a higher (
<0.02) prevalence of stage 3 CKD (24.0% vs 18.0%, eGFR 30-59), stage 4 (5.4% vs 2.7%, eGFR 15-29), and stage 5 (0.8% vs 0.5%, eGFR <15). Average annual decline of eGFR was 3.3±8.2 in DM2 versus 2.4±7.7 in non-DM (
=0.12, nonsignificant). Annual changes of eGFR and of albuminuria correlated (
=0.578,
<0.001). In multivariate analysis, age, nighttime BP, double inhibition of renin angiotensin system, albuminuria, and HbA1c >8.0% in DM2 predicted the decline in eGFR. On average, 16.2% of DM2 and 13.1% of non-DM moved each year toward a more severe stage of CKD. For initial eGFR <90 mL/min/1.73 m
, 26.4% of DM2 and 18.1% of non-DM patients showed a reduction per year >10% from the previous eGFR value (
=0.042).
Progressive deterioration of renal function each year is frequent in hypertensive diabetic and non-diabetic patients. Beyond aging, this is particularly dependent on BP control particularly at nighttime, on drug therapy, and on highly abnormal glucose control.</description><identifier>ISSN: 1178-2048</identifier><identifier>ISSN: 1176-6344</identifier><identifier>EISSN: 1178-2048</identifier><identifier>DOI: 10.2147/VHRM.S135253</identifier><identifier>PMID: 28721063</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>Age Factors ; Aged ; Albuminuria - etiology ; Albuminuria - physiopathology ; annual deterioration ; Antihypertensive Agents - therapeutic use ; Biomarkers - blood ; Blood Glucose - metabolism ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Body mass index ; Care and treatment ; Chi-Square Distribution ; Circadian Rhythm ; Collaboration ; Complications and side effects ; Development and progression ; Diabetes ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetic Nephropathies - diagnosis ; Diabetic Nephropathies - etiology ; Diabetic Nephropathies - physiopathology ; Disease Progression ; Female ; Glomerular Filtration Rate ; Glycated Hemoglobin A - metabolism ; Hospitals ; Humans ; Hypertension ; Hypertension - complications ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - physiopathology ; Hypoglycemic Agents - therapeutic use ; Kidney - physiopathology ; Kidney diseases ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Original Research ; Patients ; Physiological aspects ; Renal function ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - etiology ; Renal Insufficiency, Chronic - physiopathology ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Sleep ; Statistical analysis ; Time Factors ; Type 2 diabetes ; Urine ; Variables</subject><ispartof>Vascular health and risk management, 2017-01, Vol.13, p.231-237</ispartof><rights>COPYRIGHT 2017 Dove Medical Press Limited</rights><rights>2017. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Polonia et al. This work is published and licensed by Dove Medical Press Limited 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c576t-e0ee3858d96716b5e213d98791c3ec7923aed0a6f345b4e03c27664c3b8b62d33</citedby><orcidid>0000-0002-0133-7217</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2229719324/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2229719324?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25751,27922,27923,37010,37011,44588,53789,53791,74896</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28721063$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Polonia, Jorge</creatorcontrib><creatorcontrib>Azevedo, André</creatorcontrib><creatorcontrib>Monte, Miguel</creatorcontrib><creatorcontrib>Silva, José A</creatorcontrib><creatorcontrib>Bertoquini, Susana</creatorcontrib><title>Annual deterioration of renal function in hypertensive patients with and without diabetes</title><title>Vascular health and risk management</title><addtitle>Vasc Health Risk Manag</addtitle><description>Chronic kidney disease (CKD) complicates hypertension and diabetes. Knowledge of the deterioration rate of CKD may anticipate adjustment of therapies with renal elimination. This study evaluates the rate of annual deterioration of renal function in hypertensive patients either with type 2 diabetes (DM2) or without it (non-DM) followed for 5 years and relates it with blood pressure (BP) and glycemic control.
Out of a total of 1924 patients, 1023 patients (594 non-DM and 429 DM2, 53% female, aged 62.1±10.2 years) were evaluated over 5 years for the annual evolution of renal function (estimated glomerular filtration rate [eGFR], Modification of Diet in Renal Disease) ambulatory 24-hour blood pressure and metabolic parameters, corresponding to the analysis of 2378 patient-years.
DM2 and non-DM did not differ for age, mean 24-hour BP levels, nighttime BP, albuminuria, and body mass index. DM2 versus non-DM showed a higher (
<0.02) prevalence of stage 3 CKD (24.0% vs 18.0%, eGFR 30-59), stage 4 (5.4% vs 2.7%, eGFR 15-29), and stage 5 (0.8% vs 0.5%, eGFR <15). Average annual decline of eGFR was 3.3±8.2 in DM2 versus 2.4±7.7 in non-DM (
=0.12, nonsignificant). Annual changes of eGFR and of albuminuria correlated (
=0.578,
<0.001). In multivariate analysis, age, nighttime BP, double inhibition of renin angiotensin system, albuminuria, and HbA1c >8.0% in DM2 predicted the decline in eGFR. On average, 16.2% of DM2 and 13.1% of non-DM moved each year toward a more severe stage of CKD. For initial eGFR <90 mL/min/1.73 m
, 26.4% of DM2 and 18.1% of non-DM patients showed a reduction per year >10% from the previous eGFR value (
=0.042).
Progressive deterioration of renal function each year is frequent in hypertensive diabetic and non-diabetic patients. Beyond aging, this is particularly dependent on BP control particularly at nighttime, on drug therapy, and on highly abnormal glucose control.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Albuminuria - etiology</subject><subject>Albuminuria - physiopathology</subject><subject>annual deterioration</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Pressure</subject><subject>Blood Pressure Monitoring, Ambulatory</subject><subject>Body mass index</subject><subject>Care and treatment</subject><subject>Chi-Square Distribution</subject><subject>Circadian Rhythm</subject><subject>Collaboration</subject><subject>Complications and side effects</subject><subject>Development and progression</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetic Nephropathies - diagnosis</subject><subject>Diabetic Nephropathies - etiology</subject><subject>Diabetic Nephropathies - physiopathology</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - complications</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - physiopathology</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Kidney - physiopathology</subject><subject>Kidney diseases</subject><subject>Linear Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Original Research</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>Renal function</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - etiology</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Sleep</subject><subject>Statistical analysis</subject><subject>Time Factors</subject><subject>Type 2 diabetes</subject><subject>Urine</subject><subject>Variables</subject><issn>1178-2048</issn><issn>1176-6344</issn><issn>1178-2048</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkluLEzEUgAdR3Iu--SwDguyDrblOkhehLOourAjewKeQSc60KdOkm8ys7L83vbi2IiEknHznCzk5VfUCoynBTLz9cfXl0_Qrppxw-qg6xVjICUFMPj7Yn1RnOS8R4o1E-Gl1QqQgGDX0tPo5C2E0fe1ggORjMoOPoY5dnSCUcDcGu434UC_u15AGCNnfQb0uIIQh17_8sKhNcNtNHIfaedMWWX5WPelMn-H5fj2vvn94_-3yanLz-eP15exmYrlohgkgACq5dKoRuGk5EEydkkJhS8EKRagBh0zTUcZbBohaIpqGWdrKtiGO0vPqeud10Sz1OvmVSfc6Gq-3gZjm2qTB2x60sS0oQgwTgjFqWumgI86ajttOGdcU17udaz22K3C2vDCZ_kh6fBL8Qs_jneZMSY5YEVzsBSnejpAHvfLZQt-bAHHMGiuCaJlKFPTVP-gyjqkUPWtCiBJYUcL-UnNTHuBDF8u9diPVM045KyrECzX9D1WGg5W3MUDnS_wo4fVBwgJMPyxy7MfNX-dj8M0OtCnmnKB7KAZGetN_etN_et9_BX95WMAH-E_D0d_SItVF</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Polonia, Jorge</creator><creator>Azevedo, André</creator><creator>Monte, Miguel</creator><creator>Silva, José A</creator><creator>Bertoquini, Susana</creator><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove Medical Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0133-7217</orcidid></search><sort><creationdate>20170101</creationdate><title>Annual deterioration of renal function in hypertensive patients with and without diabetes</title><author>Polonia, Jorge ; Azevedo, André ; Monte, Miguel ; Silva, José A ; Bertoquini, Susana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c576t-e0ee3858d96716b5e213d98791c3ec7923aed0a6f345b4e03c27664c3b8b62d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Albuminuria - etiology</topic><topic>Albuminuria - physiopathology</topic><topic>annual deterioration</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Biomarkers - blood</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Pressure</topic><topic>Blood Pressure Monitoring, Ambulatory</topic><topic>Body mass index</topic><topic>Care and treatment</topic><topic>Chi-Square Distribution</topic><topic>Circadian Rhythm</topic><topic>Collaboration</topic><topic>Complications and side effects</topic><topic>Development and progression</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - diagnosis</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetic Nephropathies - diagnosis</topic><topic>Diabetic Nephropathies - etiology</topic><topic>Diabetic Nephropathies - physiopathology</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - complications</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - physiopathology</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Kidney - physiopathology</topic><topic>Kidney diseases</topic><topic>Linear Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Original Research</topic><topic>Patients</topic><topic>Physiological aspects</topic><topic>Renal function</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - etiology</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Sleep</topic><topic>Statistical analysis</topic><topic>Time Factors</topic><topic>Type 2 diabetes</topic><topic>Urine</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Polonia, Jorge</creatorcontrib><creatorcontrib>Azevedo, André</creatorcontrib><creatorcontrib>Monte, Miguel</creatorcontrib><creatorcontrib>Silva, José A</creatorcontrib><creatorcontrib>Bertoquini, Susana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Health Management Database (Proquest)</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Vascular health and risk management</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Polonia, Jorge</au><au>Azevedo, André</au><au>Monte, Miguel</au><au>Silva, José A</au><au>Bertoquini, Susana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Annual deterioration of renal function in hypertensive patients with and without diabetes</atitle><jtitle>Vascular health and risk management</jtitle><addtitle>Vasc Health Risk Manag</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>13</volume><spage>231</spage><epage>237</epage><pages>231-237</pages><issn>1178-2048</issn><issn>1176-6344</issn><eissn>1178-2048</eissn><abstract>Chronic kidney disease (CKD) complicates hypertension and diabetes. Knowledge of the deterioration rate of CKD may anticipate adjustment of therapies with renal elimination. This study evaluates the rate of annual deterioration of renal function in hypertensive patients either with type 2 diabetes (DM2) or without it (non-DM) followed for 5 years and relates it with blood pressure (BP) and glycemic control.
Out of a total of 1924 patients, 1023 patients (594 non-DM and 429 DM2, 53% female, aged 62.1±10.2 years) were evaluated over 5 years for the annual evolution of renal function (estimated glomerular filtration rate [eGFR], Modification of Diet in Renal Disease) ambulatory 24-hour blood pressure and metabolic parameters, corresponding to the analysis of 2378 patient-years.
DM2 and non-DM did not differ for age, mean 24-hour BP levels, nighttime BP, albuminuria, and body mass index. DM2 versus non-DM showed a higher (
<0.02) prevalence of stage 3 CKD (24.0% vs 18.0%, eGFR 30-59), stage 4 (5.4% vs 2.7%, eGFR 15-29), and stage 5 (0.8% vs 0.5%, eGFR <15). Average annual decline of eGFR was 3.3±8.2 in DM2 versus 2.4±7.7 in non-DM (
=0.12, nonsignificant). Annual changes of eGFR and of albuminuria correlated (
=0.578,
<0.001). In multivariate analysis, age, nighttime BP, double inhibition of renin angiotensin system, albuminuria, and HbA1c >8.0% in DM2 predicted the decline in eGFR. On average, 16.2% of DM2 and 13.1% of non-DM moved each year toward a more severe stage of CKD. For initial eGFR <90 mL/min/1.73 m
, 26.4% of DM2 and 18.1% of non-DM patients showed a reduction per year >10% from the previous eGFR value (
=0.042).
Progressive deterioration of renal function each year is frequent in hypertensive diabetic and non-diabetic patients. Beyond aging, this is particularly dependent on BP control particularly at nighttime, on drug therapy, and on highly abnormal glucose control.</abstract><cop>New Zealand</cop><pub>Dove Medical Press Limited</pub><pmid>28721063</pmid><doi>10.2147/VHRM.S135253</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-0133-7217</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1178-2048 |
| ispartof | Vascular health and risk management, 2017-01, Vol.13, p.231-237 |
| issn | 1178-2048 1176-6344 1178-2048 |
| language | eng |
| recordid | cdi_doaj_primary_oai_doaj_org_article_acbe922a477443ab8def2dcaf5cf9ad6 |
| source | Taylor & Francis_OA刊; Publicly Available Content Database; PubMed Central |
| subjects | Age Factors Aged Albuminuria - etiology Albuminuria - physiopathology annual deterioration Antihypertensive Agents - therapeutic use Biomarkers - blood Blood Glucose - metabolism Blood Pressure Blood Pressure Monitoring, Ambulatory Body mass index Care and treatment Chi-Square Distribution Circadian Rhythm Collaboration Complications and side effects Development and progression Diabetes Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - drug therapy Diabetic Nephropathies - diagnosis Diabetic Nephropathies - etiology Diabetic Nephropathies - physiopathology Disease Progression Female Glomerular Filtration Rate Glycated Hemoglobin A - metabolism Hospitals Humans Hypertension Hypertension - complications Hypertension - diagnosis Hypertension - drug therapy Hypertension - physiopathology Hypoglycemic Agents - therapeutic use Kidney - physiopathology Kidney diseases Linear Models Male Middle Aged Multivariate Analysis Original Research Patients Physiological aspects Renal function Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - etiology Renal Insufficiency, Chronic - physiopathology Retrospective Studies Risk Factors Severity of Illness Index Sleep Statistical analysis Time Factors Type 2 diabetes Urine Variables |
| title | Annual deterioration of renal function in hypertensive patients with and without diabetes |
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