Patients with Hypertensive Nephropathy and Chronic Kidney Disease Might Not Benefit from Strict Blood Pressure Control

Vettoretti, Simone; Caldiroli, Lara; Azzini, V.; Villarini, Anna; Meazza, Roberto

doi:10.1159/000495388

Cited by 10 publications

(9 citation statements)

References 36 publications

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“…Renal damage is manifested through increased capillary pressure, endothelial damage, barrier rupture, increased protein filtration, glomerular sclerosis, segmental glomerular necrosis [15], interstitial cell proliferation, matrix protein deposition, and impaired renal tubular function. Currently, the reduced glomerular filtration rate (GFR) and/or positive urinary protein is the primary criterion for the diagnosis of renal damage in patients with HTN [16]. The estimation of GFR by assessing the serum creatinine value is inevitably affected by factors such as advanced age and body weight (muscle content).…”

Section: Introductionmentioning

confidence: 99%

Relationship between Plasma Trimethylamine N-Oxide Levels and Renal Dysfunction in Patients with Hypertension

Zhou

Wang

et al. 2021

Kidney Blood Press Res

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Introduction: Trimethylamine N-oxide (TMAO) is a metabolite produced by gut bacteria. Although increased TMAO levels have been linked to hypertension (HTN) and chronic kidney disease (CKD) with poor prognosis, no clinical studies have directly addressed the relationship between them. In this study, we investigated the relationship between TMAO and renal dysfunction in hypertensive patients. Methods: We included healthy controls (n = 50), hypertensive patients (n = 46), and hypertensive patients with renal dysfunction (n = 143). Their blood pressure values were taken as the highest measured blood pressure. Renal function was evaluated using the estimated glomerular filtration rate. Plasma TMAO levels were measured using high-performance liquid chromatography tandem mass spectrometry. Results: We found significant differences in plasma TMAO levels among the 3 groups (p < 0.01). The plasma TMAO of patients with HTN was significantly higher than that of healthy people, and the plasma TMAO of patients with HTN complicated by renal dysfunction was significantly higher than either of the other groups. Patients in the highest TMAO quartile were at a higher risk of developing CKD stage 5 than those in the lowest quartile. In the receiver operating characteristic curve, the area under the curve of TMAO combined with β 2-macroglobulin for predicting renal dysfunction in patients with HTN was 0.85 (95% confidence interval 0.80–0.90). Conclusion: An elevated TMAO level reflects higher levels of HTN and more severe renal dysfunction. TMAO, combined with β 2-macroglobulin levels, may assist in diagnosing CKD in hypertensive patients. Plasma TMAO has predictive value for early kidney disease in hypertensive patients.

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Section: Introductionmentioning

confidence: 99%

Relationship between Plasma Trimethylamine N-Oxide Levels and Renal Dysfunction in Patients with Hypertension

Zhou

Wang

et al. 2021

Kidney Blood Press Res

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“…Окрім того, есенційна АГ (ЕАГ) також може бути основною ознакою безсимптомного первинного захворювання нирок [1,6]. Зміну ниркової функції найчастіше виявляють за підвищенням креатиніну в сироватці крові.…”

Section: в п о м о щ ь п р а к т и ч е с к о м у в р а ч уunclassified

Prognosis of Chronic Kidney Disease Development in Hypertensive Patients Depending on the CYP11B2 Gene (rs1799998) Allelic State of

Dzhuriak

Сидорчук

Iftoda

2020

FMEP

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The assessment of the hypertensive-mediated organ damage (HMOD) state is important for the hypertensive patients’ risk stratification.The objective: to assess the risks of chronic kidney disease (CKD) in patients with essential arterial hypertension (EAH) depending on the Cytochrome 11b2 Aldosterone Synthase Gene (CYP11B2, rs1799998) allelic state.Materials and methods. 100 hypertensive patients with hypertensive-mediated target-organ damaging (2nd stage), moderate, high or very high cardiovascular risk were enrolled in the case-control study and underwent complex of clinical-laboratory investigation with following epidemiological analysis. Mean age 59.87±8.02 y.o. CKD was diagnosed according to the National Kidney Foundation recommendations (2012) after glomerular filtration rate (GFR) decline measured by CKD-EPI equations after Creatinine, or Cystatin-C blood level. Control group included 48 practically healthy persons of relevant age. Gene’s nucleotide polymorphism CYP11B2 (–344C/T) was examined by polymerase chain reaction in 72 EAH patients and in control group.Results. The probability of CKD in the T-allele carriers of the CYP11B2 gene (rs1799998) increases after GFR decrease (cystatin-C) almost 1.5 times [OR=1.86; 95 % OR:1.01–3.58; p=0.049], especially in women [OR=2.23; 95 % OR:0.99–5.90; p=0.052]. The presence of type 2 diabetes mellitus in EAG patient increases the CKD risk 2.4 times [OR=3.29; 95 % OR:1.06–10.19; p=0.034], the obesity onset increases risk 2.08 and 2.32 times [OR=3.30; 95 % OR:1.33–8.16; p=0.009 and OR=3.58; 95 % OR:1.02–9.34; p=0.048, respectively], 3rd degree blood pressure elevation increases the probability of CKD almost three times [OR=5.06; 95 % OR:1.942–13.23; p<0.001]. Hyperaldosteronemia increases the CKD risk in EAH patients 1.3 times [OR=5.29; 95 % OR:1.15–24.37;p=0.02].Conclusion. The CKD risk (after creatinine) in the mutation T-allele carriers’ women increases 6.5 times (p=0.007) with the lowest probability of such changes in T-allele carriers’ men [OR = 0.15; p=0.009].

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“…Hypertension is a major risk factor for events such as stroke, myocardial infarction, and renal and heart failure [1]. Hypertensive nephropathy is the second leading cause of death in patients with chronic kidney disease worldwide [2]. Long-term hypertensive loading results in renal interstitial fibrosis, which is associated with aberrant activation of renal fibroblasts and excessive accumulation of…”

Section: Introductionmentioning

confidence: 99%

Recombinant Cellular Repressor of E1A-Stimulated Genes Protects against Renal Fibrosis in Dahl Salt-Sensitive Rats

Liu¹,

Song²,

Tian³

et al. 2020

Am J Nephrol

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Background: Human cellular repressor of E1A-stimulated genes (CREG) is a secreted glycoprotein that attenuates angiotensin II-induced hypertension, alleviates myocardial fibrosis, and improves heart function. However, the role of CREG in high-salt (HS) diet-induced hypertensive nephropathy is unclear. Methods: To determine the effects and molecular mechanisms of CREG in HS diet-induced hypertensive nephropathy, we established a hypertensive nephropathy animal model in Dahl salt-sensitive (SS) rats fed a HS diet (8% NaCl, n = 20) for 8 weeks. At week 4 of HS loading, these rats were administered recombinant CREG (reCREG; 35 µg/kg·day, n = 5) and saline (n = 5) via subcutaneously implanted pumps and were also administered the vasodilator hydralazine (20 mg/kg·day, n = 5) in drinking water. We used hematoxylin and eosin staining, Masson's trichrome staining, immunohistochemical labeling, western blotting, RT-PCR, and Tunel staining to determine the signaling pathways of CREG in HS diet-induced hypertensive nephropathy. Results: After 8 weeks of HS intake, the Dahl SS rats developed renal dys-function and severe renal fibrosis associated with reductions of 78 and 67% in CREG expression, respectively, at both mRNA and protein levels in the kidney. Administration of reC-REG improved renal function and relieved renal fibrosis. Administration of CREG also inhibited monocyte infiltration and reduced apoptosis in the kidney cells. CREG overexpression upregulated forkhead box P1 expression and inhibited the transforming growth factor-β1 signaling pathway. Conclusion: Our study shows that CREG protected the kidney against HS-diet-induced renal damage and provides new insights into the mechanisms underlying kidney injury.

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Patients with Hypertensive Nephropathy and Chronic Kidney Disease Might Not Benefit from Strict Blood Pressure Control

Cited by 10 publications

References 36 publications

Relationship between Plasma Trimethylamine N-Oxide Levels and Renal Dysfunction in Patients with Hypertension

Relationship between Plasma Trimethylamine N-Oxide Levels and Renal Dysfunction in Patients with Hypertension

Prognosis of Chronic Kidney Disease Development in Hypertensive Patients Depending on the CYP11B2 Gene (rs1799998) Allelic State of

Recombinant Cellular Repressor of E1A-Stimulated Genes Protects against Renal Fibrosis in Dahl Salt-Sensitive Rats

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