Treatment of Hypertension Induced Albuminuria

Knežević, Tamara; Gellineo, Lana; Jelaković, Ana; Premužić, Vedran; Dika, Živka; Laganović, Mario; Jelaković, Bojan

doi:10.2174/1381612825666181126170354

Cited by 5 publications

(4 citation statements)

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“…Previous reports have shown that greater albuminuria is associated with subsequent renal events 47 . Furthermore, higher BP is associated with an increase in renal events, especially albuminuria 48,49 . It is clear that the number of events increases as the observation period increases.…”

Section: Discussionmentioning

confidence: 90%

“…47 Furthermore, higher BP is associated with an increase in renal events, especially albuminuria. 48,49 It is clear that the number of events increases as the observation period increases. Although no clear reason is given for ΔMAP, it is possible that the higher the baseline MAP, the greater ΔMAP is likely to be, and that the decrease in GFR associated with the decrease in MAP may be manifested as an event risk.…”

Section: Discussionmentioning

confidence: 98%

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Effect of preceding drug therapy on the renal and cardiovascular outcomes of combined sodium‐glucose cotransporter‐2 inhibitor and glucagon‐like peptide‐1 receptor agonist treatment in patients with type 2 diabetes and chronic kidney disease

Tsukamoto,

Kobayashi,

Toyoda

et al. 2024

Diabetes Obesity Metabolism

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AimTo conduct a post hoc subgroup analysis of patients with type 2 diabetes (T2D) from the RECAP study, who were treated with sodium‐glucose cotransporter‐2 (SGLT2) inhibitor and glucagon‐like peptide 1 receptor agonist (GLP‐1RA) combination therapy, focusing only on those patients who had chronic kidney disease (CKD), to examine whether the composite renal outcome differed between those who received SGLT2 inhibitor treatment first and those who received a GLP‐1RA first.MethodsWe included 438 patients with CKD (GLP‐1RA‐first group, n = 223; SGLT2 inhibitor‐first group, n = 215) from the 643 T2D patients in the RECAP study. The incidence of the composite renal outcome, defined as progression to macroalbuminuria and/or a ≥50% decrease in estimated glomerular filtration rate (eGFR), was analysed using a propensity score (PS)‐matched model. Furthermore, we calculated the win ratio for these composite renal outcomes, which were weighted in the following order: (1) both a ≥50% decrease in eGFR and progression to macroalbuminuria; (2) a decrease in eGFR of ≥50% only; and (3) progression to macroalbuminuria only.ResultsUsing the PS‐matched model, 132 patients from each group were paired. The incidence of renal composite outcomes did not differ between the two groups (GLP‐1RA‐first group, 10%; SGLT2 inhibitor‐first group, 17%; odds ratio 1.80; 95% confidence interval [CI] 0.85 to 4.26; p = 0.12). The win ratio of the GLP‐1RA‐first group versus the SGLT2 inhibitor‐first group was 1.83 (95% CI 1.71 to 1.95; p < 0.001).ConclusionAlthough the renal composite outcome did not differ between the two groups, the win ratio of the GLP‐1RA‐first group versus the SGLT2 inhibitor‐first group was significant. These results suggest that, in GLP‐1RA and SGLT2 inhibitor combination therapy, the addition of an SGLT2 inhibitor to baseline GLP‐1RA treatment may lead to more favourable renal outcomes.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 98%

Effect of preceding drug therapy on the renal and cardiovascular outcomes of combined sodium‐glucose cotransporter‐2 inhibitor and glucagon‐like peptide‐1 receptor agonist treatment in patients with type 2 diabetes and chronic kidney disease

Tsukamoto,

Kobayashi,

Toyoda

et al. 2024

Diabetes Obesity Metabolism

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“…Previous studies have demonstrated that TFA intake contributes to the development of hypertension [ 48 ]. Evidence suggests that hypertension, a risk factor for CKD, is linked to an increase in albuminuria [ 49 ]. In addition, the associations between the different TFAs and the ACR in our study were also significant in nondiabetic participants.…”

Section: Discussionmentioning

confidence: 99%

Positive associations between different circulating trans fatty acids (TFAs) and urinary albumin excretion among adults in the U.S.: a population-based study

Zhou,

Wei,

Gao

et al. 2023

Lipids Health Dis

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Background It is well established that the consumption of trans-fatty acids (TFAs) can increase the incidence of total mortality, cardiovascular disease, cancer, and diabetes. However, there are still no demographic studies on the effects of circulating TFA isoforms on the albumin-creatinine ratio (ACR), an early marker of chronic kidney disease. Our goal was to explore the possible relationships between TFAs and ACR. Methods In this study, complete TFAs and urinary ACR data were collected from the National Health and Nutrition Examination Survey (NHANES) (2009–2010 and 1999–2000 cycles). The independent linear relationships between different circulating TFA isoforms and the ACR were examined by performing multivariable linear regression models. Machine learning was used to analyze the contribution of the different TFA isoforms to the ACR. To assess the nonlinearity of the relationship, smooth curve fitting and an analysis of threshold effect were performed, and a stratified analysis was conducted to identify possible susceptible populations. Results Our analysis included a total of 3785 individuals. Elaidic acid, linolelaidic acid, and sum TFAs were shown to be positively associated with the ACR after full adjustment by weighted multivariable regression analysis. In the subgroup analysis, the positive associations were maintained in participants with hypertension and without diabetes. In the XGBoost model of the ACR, Sum TFAs were found to be the most crucial factor. In addition, smooth curve fitting showed that there was a nonlinear relationship between the different TFAs and the ACR, and there was a saturation point. Conclusions Our study demonstrated that TFA isoforms were positively and independently correlated with urinary albumin excretion, especially in participants with hypertension and without diabetes. This suggested that reducing trans fatty acid intake may reduce the risk of renal events.

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“…In the case of dyslipidemia, several reviews on medication approaches highlighted the efficacy of pharmacological interventions [9,10]. Likewise, successful MAU management with medication was proved in some trials [11,12]. Considering DLP and MAU management as part of comprehensive management strategies for hypertension, healthcare professionals can mitigate the risk of CVD complications and improve patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a Health Education Program in Hypertensive Patients with Dyslipidemia and/or Microalbuminuria: A Quasi-Experimental Study in Vinh Long Province, Vietnam

Le,

Nguyen,

Pham

et al. 2023

Healthcare

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Introduction: Hypertension, a major health concern, is associated with significant mortality and disease burden worldwide, including Vietnam. Comprehensive interventions targeting medication, lifestyle modifications, dyslipidemia (DLP), and microalbuminuria (MAU) are vital for effective hypertension management and reducing the risk of cardiovascular disease complications (CDV). While medication interventions have proven efficacy, the evidence regarding the effectiveness of community-based health education interventions in managing DLP and MAU is limited. Therefore, this study aims to evaluate the effectiveness of community health education interventions in reducing hypertension risk factors and achieving hypertension management objectives, as well as managing DLP and MAU among hypertension patients. Methods: A quasi-experimental study was conducted on 330 hypertensive patients with dyslipidemia (DLP) and/or microalbuminuria (MAU) who were divided into a control group (n = 164) and an intervention group (n = 166). The control group received standard national hypertension management, while the intervention group received additional intensive health education provided by trained volunteers. The effectiveness of the intervention was assessed by comparing outcomes such as lifestyle factors, BMI control, treatment adherence, hypertension control, and DLP and MAU status between the two groups before and after a two-year intervention period. Results: The health education intervention resulted in significant reductions in dietary risk factors, specifically in fruit and vegetable consumption (p < 0.001). There was a lower prevalence of high salt intake in the intervention group compared to the control group (p = 0.002), while no significant differences were observed in other dietary factors. Smoking habits and low physical activity significantly decreased in the intervention group, with a notable disparity in physical activity proportions (p < 0.001). Both groups showed significant improvements in achieving hypertension management targets, with the intervention group demonstrating superior outcomes. The intervention was effective in reducing the prevalence of risk factors, particularly treatment non-adherence, blood pressure control, and low physical activity. Additionally, the intervention group had a higher likelihood of achieving DLP and MAU control compared to the control group. Conclusions: This study underscored the additional positive impact of incorporating health education by non-professional educators in achieving favorable outcomes, including better control of BMI, blood pressure, medication adherence, and management of dyslipidemia (DLP) and microalbuminuria (MAU). Further research is warranted to fully explore the potential of health education in primary healthcare settings and maximize its effectiveness.

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Treatment of Hypertension Induced Albuminuria

Cited by 5 publications

References 0 publications

Effect of preceding drug therapy on the renal and cardiovascular outcomes of combined sodium‐glucose cotransporter‐2 inhibitor and glucagon‐like peptide‐1 receptor agonist treatment in patients with type 2 diabetes and chronic kidney disease

Effect of preceding drug therapy on the renal and cardiovascular outcomes of combined sodium‐glucose cotransporter‐2 inhibitor and glucagon‐like peptide‐1 receptor agonist treatment in patients with type 2 diabetes and chronic kidney disease

Positive associations between different circulating trans fatty acids (TFAs) and urinary albumin excretion among adults in the U.S.: a population-based study

Effectiveness of a Health Education Program in Hypertensive Patients with Dyslipidemia and/or Microalbuminuria: A Quasi-Experimental Study in Vinh Long Province, Vietnam

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