EFFECTS OF ALLOPURINOL ON RENAL FUNCTION DECLINE IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASES

Aim: To evaluate retrospectively the effects of allopurinol treatment on renal function decline in non-gouty hypertensive patients with moderate-to-severe CKD. Methods: We selected 22 patients treated with allopurinol (A) (100–300 mg/die) that were compared with 44 subjects not treated with this drug (B), matched with A for estimated glomerular filtration rate (eGFR), age, gender and blood pressure values. Results: After a mean follow-up period of 16 months no significant difference was observed between the two groups regarding eGFR decline (A: -6.8 ± 11.6 ml/min/1.73 m2; B: -4.2 ± 9.3 ml/min/1.73 m2). Furthermore, the percentage of subjects with a value of eGFR reduction above the median w…

RELATIONSHIP BETWEEN OBESITY AND LEFT VENTRICULAR MASS IN CAUCASIAN HYPERTENSIVE SUBJECTS. DOES SEX MATTER?

Objective The excess of adiposity affects the heart through haemodynamic and non haemodynamic mechanisms leading to left ventricular hypertrophy (LVH) and ultimately to heart failure. It has been been previously observed, in a large study performed in American Indians, that the impact of obesity on left ventricular mass (LVM) is greater in women than men, while the results of other investigations carried out in other ethnic groups have yielded conflicting results .The aim of our study was to evaluate the potential influence of gender on the relationships between obesity and LVM in Caucasian patients with essential hypertension (EHs) . Design and method We enrolled 724 subjects with EH (mean…

Early Vascular Aging in Normotensive Patients With Systemic Lupus Erythematosus

Connective tissue diseases, like systemic lupus erythematosus (SLE), are associated with early and accelerated atherosclerosis. Recently, the concept of “early vascular aging” (EVA) has been more widely accepted. Aortic stiffness is one of the important markers of EVA. We evaluated EVA and subclinical atherosclerosis, by measuring aortic pulse wave velocity (aPWV) and carotid intima–media thickness (cIMT), in 50 normotensive patients with SLE (mean age: 39 ± 12 years). We compared these participants with 50 age- and sex-matched patients with essential hypertension (EH) and 20 healthy controls. Each participant underwent 24-hour ambulatory blood pressure monitoring (ABPM), aPWV, and cIMT me…

Relationship of a Body Shape Index and Body Roundness Index with carotid atherosclerosis in arterial hypertension.

Background and aims: A Body Shape Index (ABSI) and Body Roundness Index (BRI) are two new anthropometric adiposity indices that have shown to be associated better than BMI with adipose abdominal tissue, with the onset of diabetes and the risk of premature death. Little is known about the influence of ABSI and BRI on subclinical vascular damage. The study was aimed to assess the relationship between ABSI and BRI with carotid atherosclerosis damage in subjects with arterial hypertension. Methods and results: A total of 468 patients with arterial hypertension (30–80 years old) were enrolled; adiposity indices were calculated (BMI, WC, ABSI, BRI) and carotid ultrasonographic examination was per…

ASSOCIATION OF RENAL RESISTIVE INDEX WITH CAROTID INTIMA-MEDIA THICKNESS IN HYPERTENSIVE PATIENTS

Average real variability of 24-h systolic blood pressure is associated with microalbuminuria in patients with primary hypertension.

Limited and conflicting data are available about the association between short-term blood pressure (BP) variability and urinary albumin excretion rate (uAER). The objective of our study was to analyze the relationships between microalbuminuria (MAU), defined as an uAER between 20 and 200 μg min(-1), and short-term BP variability (BPV), assessed as average real variability (ARV), weighted s.d. of 24-h BP and as s.d. of daytime and night-time BP. The study population consisted of 315 untreated essential hypertensives with normal estimated glomerular filtration rate (>60 ml min(-1) per 1.73 m(2)), who underwent 24-h ambulatory BP monitoring and 24-h uAER determination. MAU was detected in 82 (…

RELATIONSHIP BETWEEN AORTIC PULSE WAVE VELOCITY AND RENAL RESISTIVE INDEX IN HYPERTENSIVE PATIENTS.

INTRODUCTION: The assessment of renal hemodynamic parameters by duplex Doppler sonography has been used for many years as a diagnostic tool in the daily workup of kidney diseases. Recent data suggest that these parameters, especially the intrarenal resistive index (RI), may be also associated with systemic vascular changes and cardiovascular risk. However, conflicting data exist about the independent association of aortic stiffness with RI. AIM: The aim was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (PWV), in the hypertensive subjects consecutively attending our hypertension centre. METHODS: We enrolled 264 subjects, aged between 3…

PP.04.22

ASSOCIATION OF RENAL RESISTIVE INDEX WITH MARKERS OF EXTRARENAL VASCULAR CHANGES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Introduction: Recent data suggest that renal hemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RRI), may be associated with systemic vascular changes. However, limited and conflicting data exist about the relationship between aortic stiffness and RI in autoimmune diseases, like systemic lupus erythematosus (SLE). Aim: To evaluate the relationship between RRI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), and between RRI and carotid atherosclerosis, evaluated by intima-media thickness (IMT) measurement in patients with SLE. Methods: In this cross-sectional study, we enrolled 39 SLE subjects (mean age 39 years) tha…

Association between uric acid and renal function in hypertensive patients: which role for systemic vascular involvement?

The role of systemic vascular involvement in mediating the association between serum uric acid (SUA) and renal function in hypertension has not been explored. Main purpose of our study was to investigate whether morphofunctional vascular changes, assessed as carotid intima-media thickness (cIMT) and aortic pulse wave velocity (aPWV), might mediate the association between SUA and renal damage. We enrolled 523 hypertensive subjects with or without chronic kidney disease and divided population into tertiles of SUA based on sex-specific cutoff values. cIMT and aPWV were higher in uppermost SUA-tertile patients when compared to those in the lowest ones (all P < .001). Uricemia strongly correlate…

Relationships between mild hyperuricaemia and aortic stiffness in untreated hypertensive patients.

Background and aims: Clinical studies exploring the relationship between serum uric acid (SUA) and arterial stiffness yielded conflicting results. Only in a few of these studies, arterial distensibility was examined by measuring aortic pulse wave velocity (PWV), which is considered the gold standard for evaluating arterial stiffness. In none of the previous investigations was the influence of SUA on aortic distensibility assessed, taking into account the effect of albuminuria. The purpose of our study was to comprehensively analyse the relationships between SUA and aortic PWV in a group of essential hypertensive patients. Methods and results: We enrolled 222 untreated and uncomplicated hype…

[OP.3B.03] INFLUENCE OF SUBCLINICAL RENAL DAMAGE ON EARLY VASCULAR AGING IN PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Objective: It is well known that kidney is frequently involved in patients with Systemic Lupus Erythematosus (SLE) However, conflicting data exist about the impact of renal involvement on vascular damage in this group of patients. The aim of this study was to evaluate the influence of renal damage on assessed by aortic pulse wave velocity (aPWV), evaluated a by intima-media thickness (IMT) measurement and assessed by renal resistive index (RRI) measurement, in patients with SLE. Design and method: We enrolled 52 SLE subjects (mean age 39 +/- 12 years), divided in two subgroups according to ACR/SLICC classification: patients with lupus nephritis, (LNG), and individuals presenting other featu…

CORRELATIONS BETWEEN NON INVASIVE RENAL INDEX AND MARKERS OF ATHEROSCLEROSIS IN LUPUS PATIENTS.

Objective: Recent data suggest that renal haemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RI), may be associated with systemic vascular changes in some groups of patients. However, conflicting data exist about the relationship between aortic stiffness and RI in autoimmune disease, like systemic lupus The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), and carotid atherosclerosis, evaluated by intimal medial thickness measurement(IMT) in patients with SLE. Design and method: Cross-sectional study. We enrolled 39 SLE subjects (mean age 39 years). Each …

RELATIONSHIPS OF SERUM URIC ACID WITH PLASMA RENIN ACTIVITY AND PLASMA ALDOSTERONE IN UNTREATED HYPERTENSIVE SUBJECTS

In experimental studies conducted in rats, raising serum uric acid (SUA) levels resulted in stimulation of intrarenal renin expression. Studies in humans exploring the association of SUA with plasma renin activity (PRA) yielded conflicting results. Moreover, little is known about the relationship between plasma aldosterone concentration (PAC) and SUA. The aim of our study was to analyse the relationships between SUA, PRA and PAC and the influence of age and gender on these relationships in a group of subjects with primary hypertension. We enrolled 281 patients (men 59%), with untreated primary hypertension and normal renal function. The study population wad divided in two subgroups on the b…

Association of renal resistive index with aortic pulse wave velocity in hypertensive patients

Background: Recent data suggest that renal haemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RI), may be associated with systemic vascular changes. However, conflicting data exist about the independent relationship between aortic stiffness and RI. The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), in hypertensive patients. Design: Cross-sectional study. Methods: We enrolled 264 hypertensive subjects aged between 30 and 70 years. They were divided into two groups, either with normal renal function (n=140) or with chronic kidney disease (CKD) (n=124). E…

ABSENCE OF AN ASSOCIATION BETWEEN SHORT-TERM BLOOD PRESSURE VARIABILITY AND MILD RENAL DYSFUNCTION IN ESSENTIAL HYPERTENSIVE PATIENTS.

Introduction: Studies investigating the prognostic implications of short-term blood pressure (BP) variability (STBPV), expressed as standard deviation (SD) and assessed by noninvasive 24-h ambulatory BP monitoring (ABPM), yielded conflicting results. In last years further indices of STBPV have been proposed. Among these, the 24-h BP average real variability (ARV) seems to be associated with an increased cardiovascular risk more closely than the SD. Little is known about the association between mild renal dysfunction (MRD) and STBPV, and particularly between 24-h BP ARV and MRD. Aim: To analyse, in a group of essential hypertensives, the relationships between MRD and STBPV, expressed as SD o…

ASSOCIATION OF RENAL RESISTIVE INDEX WITH AORTIC PULSE WAVE VELOCITY IN HYPERTENSIVE PATIENTS.

The assessment of renal hemodynamic parameters by duplex Doppler sonography has been used for many years as a diagnostic tool in the daily work-up of kidney diseases. Recent data suggest that these parameters, especially the intrarenal resistive index (RI) may be also associated with systemic vascular changes and with an enhanced cardiovascular risk. However, conflicting data exist in literature about the independent association of aortic stiffness with RI. The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (PWV), in the hypertensive subjects consecutively attending our hypertension centre. We enrolled 264 subject…

EARLY VASCULAR AGING IN NORMOTENSIVE SUBJECTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. COMPARISON WITH YOUNG HYPERTENSIVE PATIENTS

Introduction: It is well known that connective tissue diseases, like Systemic Lupus Erythematosus, are associated with early and accelerated atherosclerosis. During the last year, it has well established the concept of ‘‘Early vascular aging’’ (EVA), whose the aortic stiffness represents one of the most important markers. Aim: To evaluate early vascular aging, assessed by measuring Aortic pulse wave velocity (aPWV), as an arterial stiffness index, in a group of normotensive patients with SLE and to compare these subjects with a group of young essential hypertensive (EH) individuals.Methods: In this cross-sectional study we have enrolled 50 normotensive SLE subjects (45 women and 5 men) with…

ASSOCIATION BETWEEN RENAL RESISTIVE INDEX AND CAROTID INTIMA-MEDIA THICKNESS IN HYPERTENSIVE PATIENTS.

Introduction: The assessment of renal hemodynamic parameters by duplex Doppler sonography has been used for many years as a diagnostic tool in the daily work-up of kidney diseases. Recent data suggest that these parameters, especially the intrarenal resistive index (RI) may be also associated with changes of the systemic vascular tree and with an enhanced cardiovascular risk. However, conflicting data exist in literature about the independent association of carotid intima-media thickness (IMT) with RI. Aim: To evaluate the relationship between RI and carotid IMT in the hypertensive subjects consecutively attending our hypertension centre. Methods: We enrolled 264 subjects, aged between 30 a…

RELATIONSHIP BETWEEN ASYMPTOMATIC HYPERURICEMIA AND RENAL FUNCTION DECLINE IN HYPERTENSIVE SUBJECTS.

Introduction: It is well known that the deposition of uric acid crystals exert direct toxic effect on the renal parenchyma and vasculature. Both experimental and some clinical studies suggest the possibility that an increased uric acid level can lead to kidney disease even without deposition of uric acid crystals. However, other studies yielded conflicting results, especially regarding the role of uric acid in the progression of established kidney disease. Aim: To evaluate retrospectively the relationship between asymptomatic hyperuricemia and renal function decline in non-gouty hypertensive patients. Methods: We enrolled 97 hypertensive subjects, 48 with chronic kidney diseases (CKD) and 4…