Short‐Term Systolic Blood Pressure Variability and Kidney Disease Progression in Patients With Chronic Kidney Disease: Results From C‐STRIDE

Wang, Qin; Wang, Yu; Wang, Jinwei; Zhang, Luxia; Zhao, Ming‐Hui; Wang, Xiaoqin; Yuan, Jun; Zhou, Qiaoling; Yuan, Qiongjing; Chen, Menghua; Zhou, Xiaoling; S, Fu; Li, Shaomei; Zha, Yan; Huang, Rongsai; Liu, Zhangsuo; Zhang, Jun; Wang, Li; Liao, Pu; Liu, Jian; Li, Suhua; Xiong, Zuying; Liang, Wei; Zhao, Jinghong; Mu, Jiao; Lian, Xin; Liao, Yunjuan; Gan, Hua; Liao, Liping; Wang, Rong; Lv, Zhimei; Liao, Yunhua; Pan, Ling; Yang, Xiaoping; Lin, Zhifeng; Tong, Zongwu; Zhu, Yun; He, Qiang; Wu, Fuquan; Li, Rong; Rong, Kai; Wang, Caili; Zhang, Yanhui; Wang, Yue; Wen, Tao; Wu, Hua; Bán, Zoltán; Li, Rongshan; Wang, Lihua; Du, Feng; Wu, Yonggui; Zhang, Wei; Lin, Shan; Xu, Pengcheng; Lin, Hongli; Zhao, Hong; Pei, Fei; Zhang, Haisong; Gao, Yan; Sun, Luying; Li, Xia; Wang, Wenke; Lv, Fengling; Wang, Deguang; Wang, Xuerong; Xu, Di; Tang, Lijun; Ma, Yingchun; Wang, Tingting; Fu, Ping; Wang, Tingli; Xing, Changying; Zhang, Chengning; Xu, Xudong; He, Hongyong; Liao, Xiaohui; Xie, Shengkun; Hu, Guicai; Huang, Lan

doi:10.1161/jaha.120.015359

Cited by 17 publications

(10 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 Wang and colleagues reported that wSD was associated with the risk of dialysis initiation and/or transplantation in patients with CKD. 21 However, in the telehealth-based Vascular health Assessment of the hypertensive (VASOTENS) Registry, 24-h SBP ARV was not associated with neither decreased eGFR nor increased urine albumin excretion in hypertensive patients. 22 Due to conflicting data, more evidence is still needed to comprehensively investigate the impact of mean BP and various BPV parameters on renal function decline in hypertensive patients.…”

Section: Discussionmentioning

confidence: 98%

“…20 Wang and colleagues reported that wSD was associated with the risk of dialysis initiation and/or transplantation in patients with CKD. 21 To the best of our knowledge, the current study first conducted a prospective evaluation of the relationship between five different short-term BPV parameters derived from ABPM and hypertensive nephropathy in Han Chinese hypertensive patients. The current study showed that 24-h mean BP was more important than shortterm BPV in the prevention of hypertensive nephropathy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

24‐h ambulatory blood pressure variability and hypertensive nephropathy in Han Chinese hypertensive patients

Hung

Huang

Chung

et al. 2020

J of Clinical Hypertension

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

24‐h ambulatory blood pressure variability and hypertensive nephropathy in Han Chinese hypertensive patients

Hung

Huang

Chung

et al. 2020

J of Clinical Hypertension

View full text Add to dashboard Cite

show abstract

“…C-STRIDE is an ongoing cohort study initiated in November 2011, which includes patients with stage 1–4 CKD and various etiologies in 39 tertiary academic hospitals around China. The detailed study design and methods have been published previously [10, 11]. There are 2 criteria to be eligible for enrollment.…”

Section: Methodsmentioning

confidence: 99%

Longitudinal Follow-Up and Outcomes for Chinese Patients with Stage 1–4 Chronic Kidney Disease

Wang

et al. 2021

Kidney Dis

Self Cite

View full text Add to dashboard Cite

Introduction: Understanding heterogeneity in the prognosis of chronic kidney disease (CKD) has implications in management of patients. We aimed to evaluate the comparative risk of end-stage kidney disease (ESKD), cardiovascular (CV) events, and death among patients with CKD in China. Methods: In total, 3,700 patients with CKD stage 1–4 were recruited from 39 clinical centers in China between 2011 and 2016. New occurrence of ESKD, CV events, and all-cause mortality was recorded until the end of 2017. The crude incidence rate was calculated for each outcome. Ratios of incidence between different outcomes were generated with 95% confidence interval (CI) estimated by 1,000 times of bootstrapping. Multivariable adjusted Cox regression models accounting for competing risk between the outcomes were used to evaluate the association of risk factors with the outcomes. Results: The population mean age was 50 ± 14 years, with 58.2% male and 60.3% of glomerulonephritis. After a median follow-up of 4.65 years (interquartile range [IQR]: 3.71–5.60 years) for ESKD, 4.76 years (IQR: 3.97–5.76 years) for CV events, and 4.84 years (IQR: 3.97–5.76 years) for death, the incidence rates of the 3 outcomes were 3.1, 1.5, and 0.92/100 patient-years, respectively. The ratio for the incidence of ESKD and CV events was 2.15 (95% CI: 1.87, 2.53) and that for incidence of ESKD and death was 3.41 (95% CI: 2.88, 4.08). Significant differences regarding the ratios were detected through levels of age, history of CV disease, the estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (uACR), and etiology of CKD. In the Cox regression model adjusting for traditional CV and kidney-specific risk factors, older age was associated with a higher risk of CV events and death but a lower risk of ESKD (hazard ratios [HRs] = 1.45 [95% CI: 1.29, 1.64], 1.48 [95% CI: 1.29, 1.70], and 0.78 [95% CI: 0.73, 0.84] per 10 year increase, respectively). By comparison, reduced eGFR was associated with a higher risk of ESKD and death, rather than CV events (HRs = 3.62 [95% CI: 2.96, 4.43], 1.30 [95% CI: 1.02, 1.66], and 1.22 [95% CI: 0.99, 1.49] per 30.26 mL/min/1.73 m2 increase, respectively). Similar patterns were seen for increased uACR (HRs = 1.42 [95% CI: 1.30, 1.55], 1.17 [95% CI: 1.05, 1.30], and 1.07 [95% CI: 0.99, 1.17] per 1 natural log-transformed value increase, respectively). Conclusion: ESKD was more likely to occur than CV events and death in the population with CKD stage 1–4 in China. Traditional risk factors contributed differently to the comparative risk of the outcomes.

show abstract

“…Tubular injury do to hypertension is associated to damage of peritubular capillaries which triggers hypoxia, microvasculature dysfunction, inflammation and finally turns into intersitial fibrosis [37]. Together with chronic uncontrolled hypertension, BP variability is also associated to a high risk of renal outcomes [38,39]. Observations from our cohort of CKD patients linked BP variability with a prevalence of sleep disorders such as obstructive sleep apnea, insomnia and restless leg syndrome further supporting the hypothesis that endothelial dysfunction and glomerular damage play a crucial role in the development of BP variation and in worsen disease progression in these patients [40][41][42].…”

Section: Oxidative Stress Damage In Ckd and Kidney Failure With Or Without Replacement Therapy Patientsmentioning

confidence: 99%

The Pivotal Role of Oxidative Stress in the Pathophysiology of Cardiovascular-Renal Remodeling in Kidney Disease

et al. 2021

View full text Add to dashboard Cite

The excessive activation of the renin-angiotensin system in kidney disease leads to alteration of intracellular pathways which concur altogether to the induction of cardiovascular and renal remodeling, exposing these patients since the very beginning of the renal injury to chronic kidney disease and progression to end stage renal disease, a very harmful and life threatening clinical condition. Oxidative stress plays a pivotal role in the pathophysiology of renal injury and cardiovascular-renal remodeling, the long-term consequence of its effect. This review will examine the role of oxidative stress in the most significant pathways involved in cardiovascular and renal remodeling with a focus on the detrimental effects of oxidative stress-mediated renal abnormalities on the progression of the disease and of its complications. Food for thoughts on possible therapeutic target are proposed on the basis of experimental evidences.

show abstract

Short‐Term Systolic Blood Pressure Variability and Kidney Disease Progression in Patients With Chronic Kidney Disease: Results From C‐STRIDE

Cited by 17 publications

References 33 publications

24‐h ambulatory blood pressure variability and hypertensive nephropathy in Han Chinese hypertensive patients

24‐h ambulatory blood pressure variability and hypertensive nephropathy in Han Chinese hypertensive patients

Longitudinal Follow-Up and Outcomes for Chinese Patients with Stage 1–4 Chronic Kidney Disease

The Pivotal Role of Oxidative Stress in the Pathophysiology of Cardiovascular-Renal Remodeling in Kidney Disease

Contact Info

Product

Resources

About