BACKGROUND AND OBJECTIVES: Brachial artery measures of BP are associated with increasing degrees of proteinuria. Whether central measures of BP or vascular stiffness are associated with increased risk of proteinuria in patients with chronic kidney disease (CKD) is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Measurements of central and brachial artery BP, and aortic pulse wave velocity (PWV) were performed in a cross-sectional cohort of patients with CKD (n = 2144) from the Chronic Renal Insufficiency Cohort (CRIC) study to determine factors which predict increased risk of proteinuria. Multivariate analysis stratified by diabetes included age, ethnicity, gender, estimated glomerular filtration rate (GFR), waistline, smoking, heart rate, and medications to evaluate the relationship of hemodynamic factors and proteinuria. RESULTS: Brachial artery systolic BP (SBP) was important as an explanatory factor for variations in proteinuria among both diabetics (R(2) = 0.40, P < 0.0001) and non diabetics (R(2) = 0.38, P < 0.001). Measures of peripheral pulse pressure (PP), central SBP, and central pulse pressure added little to the explained variation in proteinuria beyond brachial artery SBP, whereas PWV as a measure of vascular stiffness incrementally accounted for a significant portion of variation in proteinuria beyond that explained by brachial artery SBP in diabetics (R(2) = 0.42, P < 0.001) but not non diabetics. CONCLUSIONS: Brachial artery SBP and PWV are both associated with variations in proteinuria in patients with CKD.
BACKGROUND AND OBJECTIVES: Brachial artery measures of BP are associated with increasing degrees of proteinuria. Whether central measures of BP or vascular stiffness are associated with increased risk of proteinuria in patients with chronic kidney disease (CKD) is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Measurements of central and brachial artery BP, and aortic pulse wave velocity (PWV) were performed in a cross-sectional cohort of patients with CKD (n = 2144) from the Chronic Renal Insufficiency Cohort (CRIC) study to determine factors which predict increased risk of proteinuria. Multivariate analysis stratified by diabetes included age, ethnicity, gender, estimated glomerular filtration rate (GFR), waistline, smoking, heart rate, and medications to evaluate the relationship of hemodynamic factors and proteinuria. RESULTS:Brachial artery systolic BP (SBP) was important as an explanatory factor for variations in proteinuria among both diabetics (R(2) = 0.40, P < 0.0001) and non diabetics (R(2) = 0.38, P < 0.001). Measures of peripheral pulse pressure (PP), central SBP, and central pulse pressure added little to the explained variation in proteinuria beyond brachial artery SBP, whereas PWV as a measure of vascular stiffness incrementally accounted for a significant portion of variation in proteinuria beyond that explained by brachial artery SBP in diabetics (R(2) = 0.42, P < 0.001) but not non diabetics. CONCLUSIONS: Brachial artery SBP and PWV are both associated with variations in proteinuria in patients with CKD.
Authors: H C Gerstein; J F Mann; Q Yi; B Zinman; S F Dinneen; B Hoogwerf; J P Hallé; J Young; A Rashkow; C Joyce; S Nawaz; S Yusuf Journal: JAMA Date: 2001-07-25 Impact factor: 56.272
Authors: Kennedy Cruickshank; Lisa Riste; Simon G Anderson; John S Wright; Graham Dunn; Ray G Gosling Journal: Circulation Date: 2002-10-15 Impact factor: 29.690
Authors: Riccardo Pini; M Chiara Cavallini; Vittorio Palmieri; Niccolò Marchionni; Mauro Di Bari; Richard B Devereux; Giulio Masotti; Mary J Roman Journal: J Am Coll Cardiol Date: 2008-06-24 Impact factor: 24.094
Authors: Marc M H Hermans; Ronald Henry; Jacqueline M Dekker; Jeroen P Kooman; Piet J Kostense; Giel Nijpels; Robert J Heine; Coen D A Stehouwer Journal: J Am Soc Nephrol Date: 2007-04-25 Impact factor: 10.121
Authors: Katherine H Michener; Gary F Mitchell; Farzad Noubary; Naya Huang; Tamara Harris; Margret B Andresdottir; Runolfur Palsson; Vilmundur Gudnason; Andrew S Levey Journal: Am J Nephrol Date: 2015-06-06 Impact factor: 3.754
Authors: Rachel E Climie; Martin G Schultz; James W Fell; Lorena Romero; Petr Otahal; James E Sharman Journal: J Hum Hypertens Date: 2018-11-13 Impact factor: 3.012
Authors: Baris Gulhan; Kultigin Turkmen; Merve Aydin; Murat Gunay; Aytekin Cıkman; Murat Kara Journal: Cardiorenal Med Date: 2015-04-17 Impact factor: 2.041