Hypertension Control in Adults With CKD in China: Baseline Results From the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE)

Yan, Zhe; Wang, Yu; Li, Shaomei; Wang, Jinwei; Zhang, Luxia; Tan, Huibin; Li, Sumin; Yang, Lin; Hu, Pei; Zhang, Liping; Wang, Yan; Duan, Jian-zhao; Jiao, Sumin; Zhao, Ming‐Hui; S, Fu

doi:10.1093/ajh/hpx222

Cited by 26 publications

(34 citation statements)

References 32 publications

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“…Chronic kidney disease (CKD) has a rapidly rising worldwide prevalence (Bruck et al, ; Ku, Johansen, & McCulloch, ; Yan et al, ). Moreover, CKD patients are at particularly high risk of death due to comorbidities such as infection, hypertension, atherosclerosis, heart failure, and stroke (DeBoer et al, ; Xu et al, ).…”

Section: Introductionmentioning

confidence: 99%

Wnt/β‐catenin/RAS signaling mediates age‐related renal fibrosis and is associated with mitochondrial dysfunction

et al. 2019

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Renal fibrosis is the common pathological feature in a variety of chronic kidney diseases. Aging is highly associated with the progression of renal fibrosis. Among several determinants, mitochondrial dysfunction plays an important role in aging. However, the underlying mechanisms of mitochondrial dysfunction in age‐related renal fibrosis are not elucidated. Herein, we found that Wnt/β‐catenin signaling and renin–angiotensin system (RAS) activity were upregulated in aging kidneys. Concomitantly, mitochondrial mass and functions were impaired with aging. Ectopic expression of Klotho, an antagonist of endogenous Wnt/β‐catenin activity, abolished renal fibrosis in d‐galactose (d‐gal)‐induced accelerated aging mouse model and significantly protected renal mitochondrial functions by preserving mass and diminishing the production of reactive oxygen species. In an established aging mouse model, dickkopf 1, a more specific Wnt inhibitor, and the mitochondria‐targeted antioxidant mitoquinone restored mitochondrial mass and attenuated tubular senescence and renal fibrosis. In a human proximal tubular cell line (HKC‐8), ectopic expression of Wnt1 decreased biogenesis and induced dysfunction of mitochondria, and triggered cellular senescence. Moreover, d‐gal triggered the transduction of Wnt/β‐catenin signaling, which further activated angiotensin type 1 receptor (AT1), and then decreased the mitochondrial mass and increased cellular senescence in HKC‐8 cells and primary cultured renal tubular cells. These effects were inhibited by AT1 blocker of losartan. These results suggest inhibition of Wnt/β‐catenin signaling and the RAS could slow the onset of age‐related mitochondrial dysfunction and renal fibrosis. Taken together, our results indicate that Wnt/β‐catenin/RAS signaling mediates age‐related renal fibrosis and is associated with mitochondrial dysfunction.

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Section: Introductionmentioning

confidence: 99%

Wnt/β‐catenin/RAS signaling mediates age‐related renal fibrosis and is associated with mitochondrial dysfunction

et al. 2019

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“…However, most patients have difficulty reaching this target BP level. Prior research has repeatedly found a range of 50-75% for uncontrolled BP among patients [9][10][11]. The evidence suggests that uncontrolled BP was a major risk factor for cardiovascular morbidity and mortality in the CKD population, in addition to the development of end-stage renal disease (ESRD) [1].…”

Section: Introductionmentioning

confidence: 99%

Rate of uncontrolled blood pressure and its associated factors in patients with predialysis chronic kidney disease in Bali, Indonesia

Dharmapatni

Sriyuktasuth

Pongthavornkamol

2020

JHR

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PurposeHypertension is a key determinant for the development and progression of chronic kidney disease (CKD). The purpose of this study is to assess the rate of uncontrolled blood pressure (BP) and identify its associated factors in patients with predialysis CKD in Bali, Indonesia.Design/methodology/approachA cross-sectional study was conducted among 165 patients who attended the nephrology clinic in a central public hospital in Bali. Data were obtained by measuring BP at threshold 130/80 mmHg, as well as collected through standardized questionnaires. Univariate analysis was done using Chi-square test, and multivariate analyses were carried out using multiple logistic regression.FindingsA total of 165 patients (111 males and 54 females) with predialysis CKD participated in this study. About 64% of the participants had uncontrolled BP. In multiple logistic regression, all selected variables significantly explained 63.2% of the variance in uncontrolled BP. However, low physical activity (odds ratio [OR] = 24.287, 95% confidence interval [CI]: 3.114–189.445), unhealthy dietary pattern (OR = 10.153, 95% CI: 2.770–37.210), as well as perceived moderate stress (OR = 4.365, 95% CI: 1.024-18.609) and high stress (OR = 10.978, 95% CI: 2.602–46.312) were significantly associated with uncontrolled BP.Research limitations/implicationsThe study findings provide evidence for health care providers to improve BP control among patients with predialysis CKD.Originality/valueControlling BP among patients with predialysis CKD was poor. Lifestyle modification and stress management are keys to improving BP control.

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“…As a developing country with a heavy CKD burden, the control rate for hypertension in CKD patients in China has been improved in recent years. In the C‐STRIDE study, approximately 60% of CKD patients had a BP < 140/90 mmHg, which was higher than in such patients in previous reports . However, this is still not optimal, particularly among the participants with CKD stages 3 and 4 when compared to other studies, including the Chronic Renal Insufficiency Cohort (CRIC) .…”

Section: Discussionmentioning

confidence: 78%

“…As reported in our previous study, a total of 3472 participants were enrolled until June 2016, of whom 2873 participants had a complete record of BP measurement and/or antihypertensive medication histories. The prevalence of hypertension was 78.4%, with 2251 hypertensive CKD subjects . Among the hypertensive participants, a subgroup of 2213 subjects who had complete information on antihypertensive medication at enrollment was further analyzed in the present study.…”

Section: Methodsmentioning

confidence: 99%

“…Effective blood pressure (BP) control could provide both cardioprotective and renal protective benefits to CKD patients . Although the control rate of hypertension among Chinese CKD patients has improved in recent years, it is still not optimal. Several factors may affect hypertension control, among which appropriate utilization of antihypertensive drug(s) is considered to play an important role .…”

Section: Introductionmentioning

confidence: 99%

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Utilization of antihypertensive drugs among chronic kidney disease patients: Results from the Chinese cohort study of chronic kidney disease (C‐STRIDE)

Liu¹,

Wang²,

Wang³

et al. 2019

J of Clinical Hypertension

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The utilization of antihypertensive drugs plays an important role in blood pressure control among chronic kidney disease (CKD) patients. Limited information was available on how antihypertensive drugs were used among Chinese CKD patients. In the present study, the utilization of antihypertensive drugs among a subgroup of hypertensive participants with a complete record of antihypertensive drug information from the Chinese Cohort Study of Chronic Kidney Disease was analyzed. Among 2213 subjects, 61.7% and 26.5% had their blood pressure controlled to <140/90 mmHg and <130/80 mmHg, respectively. In total, 38.5% were on monotherapy. Of those patients who received combination therapy, 57.8% were treated with a two‐drug combination. Renin‐angiotensin system inhibitors (RASIs) were the most commonly prescribed drugs (71.2%). Only 10.2% of the patients were prescribed diuretics. After multivariable adjustment, participants taking RASI were more likely to have their blood pressure controlled to <140/90 mmHg (prevalence ratio (PR) 1.153, 95% confidence interval (CI): 1.071‐1.240). CKD stage 4 (PR 0.548, 95% CI: 0.434‐0.692) was associated with RASIs treatment. Additionally, diabetes (PR 1.498, 95% CI: 1.120‐2.004), albumin/creatinine ratio ≥300 mg/g (PR 1.547, 95% CI: 1.020‐2.344), and CKD stage 4 (PR 2.022, 95% CI: 1.223‐3.343) were associated with diuretic use. The results suggested that combination therapy, diuretics use in general, and utilization of RASIs in advanced CKD stage were insufficient in the current treatment of Chinese hypertensive CKD patients.

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Hypertension Control in Adults With CKD in China: Baseline Results From the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE)

Cited by 26 publications

References 32 publications

Wnt/β‐catenin/RAS signaling mediates age‐related renal fibrosis and is associated with mitochondrial dysfunction

Wnt/β‐catenin/RAS signaling mediates age‐related renal fibrosis and is associated with mitochondrial dysfunction

Rate of uncontrolled blood pressure and its associated factors in patients with predialysis chronic kidney disease in Bali, Indonesia

Utilization of antihypertensive drugs among chronic kidney disease patients: Results from the Chinese cohort study of chronic kidney disease (C‐STRIDE)

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