Objectives To examine the relation between static and dynamic blood pressure ( BP) measurements and the evolution of kidney function in older people. The American Heart Association explains how high blood pressure, also called hypertension, can cause kidney damage that can lead to kidney failure. Increased blood pressure and modified cardiac output is thought to play a role in this process. Here we hypothesize that the relationship between kidney.
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- Relation among Blood Pressure, Heart Rate and Creatinine in Kidney Transplanted Patients
Of these, 13 were true normotensives The mean maximum diameter was measured for both kidneys of each individual and was adjusted for height.
We had set out to only assess normotensive patients with ADPKD but because we had a significant percentage of hypertensive patients, we decided to study whether there was any relationship among the total available population 37 patients between the various parameters obtained by the ABPM and the mean kidney diameter adjusted for height.
Relationship between blood pressure and renal function.
Subsequently and because this was the main objective of the paper, the results in the subset of 17 normotensive patients by ABPM over 24 hours were analysed. When analysing the data from the group of the 17 normotensive patients, positive correlations were identified between average maximum kidney size adjusted for height and all parameters of ABPM with the exception of PP, without reaching statistical significance.The Diet for Chronic Kidney Disease
Kidney size, circadian profile and blood pressure variability Clinically, the parameter used for assessing the BP pattern was the decrease in daytime to nightime MBP. None of the 17 patients reported a riser pattern. Of the 17 normotensive patients, we decided to study those who had a physiological BP profile, maintaining 11 assessable patients with a dipper BP pattern. The nocturnal decrease in BP for this group had a negative correlation, although not statistically significant, with the increase in kidney size.
No significant differences were found in kidney size among patients with or without a dipper BP pattern.
The patients were not trained to carry out a proper home blood pressure monitoring HBPMwhich would have helped diagnose hypertension in some of the patients who reported being normotensive at home. An important aspect of this study is that 11 of the 37 patients selected Some studies have shown that patients with masked hypertension have more important subclinical organ damage than subjects with white coat hypertension or with grade I AHT, which causes this condition to carry a greater cardiovascular risk.
The relationship between renal function and blood pressure BP components has been studied in persons with diagnosed CKD, diabetes or hypertension.
Whether renal function in such cases is associated with systolic blood pressure SBPdiastolic blood pressure DBPpulse pressure is unclear. In the study we have evaluated the association between renal function test parameters and each BP component using cystatin C in 80 essential hypertensive patients and 80 age and sex matched normotensive healthy controls.
As SBP was significantly associated with kidney function across a wide range of cystatin C concentrations, even in subjects with presumably normal kidney function, this can provide a vital link in diagnosis of worsening of renal function at an early stage. For control of hypertension in patients undertaking anti-hypertensive medications this can also serve as an important marker. Body Mass Index; BP: Congestive Heart Failure; CI: Ministry of Health; NO: Systolic Blood Pressure; SD: Introduction In developing countries like India, hypertension is the leading noncommunicable disease and is estimated to be attributable for nearly 10 percent of all deaths [ 1 ].
Adult hypertension prevalence is increasing rapidly in both rural as well as in urban population [ 23 ]. The number of hypertensive individuals is anticipated to nearly double from million in to million in [ 3 ].
It recommends blood pressure criteria for defining normal blood pressure, prehypertension, hypertension stages I and IIand isolated systolic hypertension, which is a common occurrence among the elderly [ 4 ]. Even moderate elevation of arterial blood pressure is associated with a shortened life expectancy.
Dietary and lifestyle changes can improve blood pressure control and decrease the risk of associated health complications, although drug treatment is often necessary in some people.
Hypertension doubles the risk of cardiovascular diseases, including coronary heart disease, congestive heart failure, ischemic and hemorrhagic stroke, renal failure, and peripheral arterial disease [ 5 ]. Hypertension is a risk factor for renal injury and End Stage Renal Disease. The atherosclerotic, hypertension related vascular lesions lead to glomerular injury ultimately leading to glomerulosclerosis and ischemic and atrophic changes to renal tubules.
In malignant hypertension there is fibrinoid necrosis of the afferent arterioles, sometimes extending to glomerulus ultimately leading to decreased renal function.
When renal function decreases, the serum concentration of many low-molecular weight proteins increases. Recent studies have found strong association between renal function and pulse pressure in elderly persons with isolated systolic hypertension [ 8 - 13 ].
Another study found that SBP was a stronger predictor of increase in serum creatinine than DBP, pulse pressure or mean arterial pressure in an elderly population with isolated systolic hypertension [ 14 ].
Although SBP, DBP and pulse pressure are known to suggest cardiovascular risk, their relative association with renal function test parameters were not known previously. So it is of utmost importance to find out a correlation between degrees of hypertension, the serum cystatin C to find its implications in the treatment of hypertension, as mildly reduced renal function may be an underappreciated barrier in the achievement of BP targets. The sample size wasconsisting of 80 cases and 80 controls.
The study has been approved by institutional ethical committee and informed written consent was taken from both cases and controls. Medical College and Hospital, Cuttack were included in the study.
Patients with newly diagnosed Essential Hypertension were selected and diagnosed on the basis of their history, physical examination, biochemical investigations and according to the JNC 7 Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Criteria for the diagnosis of hypertension4.
The controls were selected from the department staffs and students after through medical examination, serial BP measurements and detailed history taking. Three ml of blood was collected after overnight fasting of 8 hours from all enrolled patients and healthy controls for the assessment of lipid profile, creatinine, cystatin-C levels. Although it has been reported that the kidney allograft might receive a new innervation, its physiological meaning has been largely questioned [ 910 ].
It should be noted that it has been reported a relationship between creatinine blood levels [a marker of glomerular filtration rate [GFR] and kidney function] and cardiac output, indexed by the blood pressure [BP] and the heart rate [HR] [ 11 ]. The mechanism of such relation is probably due to the strong influence of the heart output on the GFR.
Relationship between blood pressure and renal function.
In the present paper we hypothesize that the relationship between GFR and cardiac output might be impaired in early stages of kidney allograft dysfunction. To test this hypothesis, we analyzed serial data from a cohort of subjects and used these data to derive the relationship between serum creatinine [Cr] and three main parameters connected to the cardiac output, that is the heart rate, the systolic blood pressure and the diastolic blood pressure.
According to our working hypothesis, a kidney with impairment of its function should also show impaired relationship between its GFR [indexed by Cr] and the cardiac output. Methods This retrospective observational study evaluated 27 adult patients, who received a deceased kidney transplant more than 5 years before. All the patients received conventional immunosuppression therapy. The main characteristic of the subjects [anthropometric measures, years after transplant, blood chemical data] is reported in Table 1.
For their follow-up, subjects have been studied 6 times per year for two years.