0000000000776019
AUTHOR
Maria Giovanna Vario
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 Short-Term Blood Pressure Variability and Subclinical Renal Damage in Essential Hypertensive Patients
The authors aimed to analyze the relationship between subclinical renal damage, defined as the presence of microalbuminuria or an estimated glomerular filtration rate (eGFR) between 30 mL/min/1.73 m(2) and 60 mL/min/1.73 m(2) and short-term blood pressure (BP) variability, assessed as average real variability (ARV), weighted standard deviation (SD) of 24-hour BP, and SD of daytime and nighttime BP. A total of 328 hypertensive patients underwent 24-hour ambulatory BP monitoring, 24-hour albumin excretion rate determination, and eGFR calculation using the Chronic Kidney Disease Epidemiology Collaboration equation. ARV of 24-hour systolic BP (SBP) was significantly higher in patients with subc…
Ruolo della Ciclofosfamide nel trattamento del Lupus Eritematoso Sistemico in paziente afroamericana con severo incremento degli indici di funzionalità renale.
Introduzione: la Ciclofosfamide rappresenta con il Micofenolato Mofetile uno tra i farmaci di scelta nelle fasi di induzione della nefrite lupica. Tuttavia, risulta ancora controverso il suo utilizzo nei soggetti di razza afroamericana. Caso Clinico: Paziente afroamericana puerpera di 36 anni, che giungeva alla nostra osservazione dopo parto cesareo in urgenza alla 34° settimana per riscontro di preclampasia. La paziente si presentava in stato anasarcatico, oligoanurica, con severa alterazione degli indici di funzione renale (Cr 4 mg/dl) proteinuria in range nefrosico ed anemizzazione severa. Storia di TBC linfonodale. Riscontro di positività ad esami bioumorali di autoimmunità: ANA, Anti- …
Absence of an independent association between serum uric acid and left ventricular mass in Caucasian hypertensive women and men
Background and aim: Experimentally uric acid may induce cardiomyocyte growth and interstitial fibrosis of the heart. However, clinical studies exploring the relationship between serum uric acid (SUA) and left ventricular (LV) mass yielded conflicting results. The aim of our study was to evaluate the relationships between SUA and LV mass in a large group of Caucasian essential hypertensive subjects. Methods and results: We enrolled 534 hypertensive patients free of cardiovascular complications and without severe renal insufficiency. In all subjects routine blood chemistry, including SUA determination, echocardiographic examination and 24 h ambulatory blood pressure (BP) monitoring were obtai…
[PP.07.19] ASSOCIATION OF MAXIMUM SPEED OF BLOOD PRESSURE RISE DURING 24-H ABPM WITH SUBCLINICAL RENAL DAMAGE IN ESSENTIAL HYPERTENSION
Objective: Experimental studies documented that the mechanical injury of intravascular pressure on the vessel wall, which results in vascular remodelling and atherosclerosis, may be more closely associated to oscillatory than to steady laminar shear stress This suggests that the hypertensive patient's prognosis may depend not only on average BP level but also on the degree and rate of BP variation. Little is known about the relationships between early renal abnormalities and the rate of BP changes assessed by intermittent 24-h ambulatory BP monitoring (ABPM). Our study was aimed to analyse the relationships between subclinical renal damage (SRD), defined as the presence of microalbuminuria …
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…
Should reduction of increased short‐term blood pressure variability be a target of antihypertensive therapy?
Abstract It has long been known that blood pressure (BP) is characterized by marked short‐term fluctuations occurring within a 24‐h period and also by long‐term oscillations occurring over more prolonged periods of time. An increased short‐term blood pressure variability (BPV) appears to importantly contribute to target organ damage and to the enhanced cardiovascular risk of hypertensive patients, over and above the effect of an increase in mean BP levels. Reducing 24‐h mean BP is the main aim of antihypertensive therapy, but initial data are available that additional cardiovascular protection can be achieved by reducing BPV. However, to definitively prove the prognostic role of short‐term …
An Elevated Neutrophil-Lymphocyte Ratio Increases the Risk of Cardiovascular Events and of Renal Function Decline in Hypertensive Patients with CKD
Introduction: Many epidemiological studies have shown that low-grade chronic inflammation, estimated through the neutrophil-lymphocyte ratio (NLR), is linked to traditional and non-traditional cardiovascular (CV) risk factors. Aim: The aim of our study was to investigate the potential prognostic role of NLR regarding the progression of chronic kidney disease (CKD) and the development of CV events in a cohort of renal and hypertensive patients. Methods: In this retrospective observational study, 403 patients consecutively attending our Nephrology and Hypertension clinics were included. At the baseline observation and control visits in all patients, in addition to the clinical-anamnestic eval…
The Renal Dangers of an Increased Cardio-Ankle Vascular Index
Although a number of longitudinal investigations assessed the ability of aortic PWV to predict the development of kidney disfunction or progression of renal disease, little is known about the association of CAVI with the risk of renal function deterioration. In the current issue of the American Journal of Hypertension is published a paper of Itano S et al, that add a new piece of evidence in this scenario. The authors analyzed data from the national health check-up system in Japan, including 24.297 participants with normal baseline kidney function. They found that those with CAVI measurements ≥8.1 had a higher risk for CKD events compared to their counterparts with CAVI measurements <8.1…