Open AccessNoninvasive central pulse pressure is an independent determinant of renal function
Author(s) -
Xiao Wenkai,
Wen Yi,
Ye Ping,
Wang Fan,
Cao Ruihua,
Bai Yongyi,
Wu Hongmei
Publication year - 2020
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13792
Subject(s) - medicine , renal function , interquartile range , quartile , hazard ratio , kidney disease , pulse pressure , confidence interval , confounding , blood pressure , proportional hazards model , urology , cardiology
The purpose of this study was to investigate the prognostic properties of different BP measurements for renal function decrement and early chronic kidney disease (CKD) in community‐dwelling populations with normal renal function at baseline. A total of 1426 participants were included and followed for a median of 4.8 years (interquartile range, 4.5‐5.2), and central hemodynamic profile and estimated glomerular filtration rate (eGFR) were evaluated. One main outcome was the rapid eGFR decline defined as a decline in eGFR of greater than 3 mL/min per 1.73 m 2 per year; the other was the new incidence of CKD. At the end of follow‐up, mean eGFR decreased from 93.39 ± 13.46 mL/min per 1.73 m 2 to 85.72 ± 14.81 mL/min per 1.73 m 2 , and the incidence of rapid eGFR decline and CKD were 20.7% and 5.6%, respectively. In multivariate linear regression analysis, central pulse pressure (PP), age, fasting blood glucose, and concentration of homocysteine were independent determinants of the change in renal function. Not only in the prediction of rapid eGFR decline but also in the incident of CKD, baseline central PP was the only BP component that consistently independently associated with both outcomes after adjustment for various confounders. When compared with subjects in the lowest quartile of central PP, those in the highest quartile demonstrated a significantly increased risk of CKD (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.08‐2.96; P = .006). The study showed that central PP emerged as an independent predictor of the decline in renal function.