Abstract
Background: Hypertension and proteinuria are risk factors for adverse renal outcomes in patients with chronic kidney disease. This study investigated the associations of blood pressure and proteinuria on renal function in a community-based population. Methods: We analyzed data from a nationwide database of 141,514 subjects who participated in the annual "Specific Health Check and Guidance in Japan" checkup in 2008 and 2010. The study subjects were aged between 29 and 74 years, and the cohort comprised 40% men. We examined relationships between blood pressure levels, proteinuria at baseline, and the 2-year change in the estimated glomerular filtration rate (eGFR), which was determined using the Japanese equation. Results: After adjusting for possible confounders, the change in the eGFR was inversely correlated with systolic blood pressure (SBP), but not diastolic blood pressure (DBP), at baseline, irrespective of the presence of proteinuria. Compared with the lowest SBP sixtile (≤118mm Hg), eGFRs declined significantly at SBPs ≥ 134mm Hg in subjects with proteinuria, while eGFRs declined significantly at SBPs ≥ 141mm Hg in those without proteinuria. At the same SBPs, renal function decline was faster and the risk for incident renal insufficiency was higher in subjects with proteinuria compared with those without proteinuria. Conclusions: This study showed that a difference in SBP, but not DBP, is independently associated with a rapid eGFR decline in the general Japanese population, and that the association of SBP on the decline of renal function was greater in subjects with proteinuria compared with those without proteinuria.
| Original language | English |
|---|---|
| Pages (from-to) | 1150-1156 |
| Number of pages | 7 |
| Journal | American Journal of Hypertension |
| Volume | 28 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 2015 Jun 17 |
| Externally published | Yes |
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Keywords
- blood pressure
- cohort study
- hypertension
- renal function
ASJC Scopus subject areas
- Internal Medicine
Cite this
Blood Pressure, Proteinuria, and Renal Function Decline : Associations in a Large Community-Based Population. / Hirayama, Atsushi; Konta, Tsuneo; Kamei, Keita; Suzuki, Kazuko; Ichikawa, Kazunobu; Fujimoto, Shouichi; Iseki, Kunitoshi; Moriyama, Toshiki; Yamagata, Kunihiro; Tsuruya, Kazuhiko; Kimura, Kenjiro; Narita, Ichiei; Kondo, Masahide; Asahi, Koichi; Kurahashi, Issei; Ohashi, Yasuo; Watanabe, Tsuyoshi.
In: American Journal of Hypertension, Vol. 28, No. 9, 17.06.2015, p. 1150-1156.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Blood Pressure, Proteinuria, and Renal Function Decline
T2 - Associations in a Large Community-Based Population
AU - Hirayama, Atsushi
AU - Konta, Tsuneo
AU - Kamei, Keita
AU - Suzuki, Kazuko
AU - Ichikawa, Kazunobu
AU - Fujimoto, Shouichi
AU - Iseki, Kunitoshi
AU - Moriyama, Toshiki
AU - Yamagata, Kunihiro
AU - Tsuruya, Kazuhiko
AU - Kimura, Kenjiro
AU - Narita, Ichiei
AU - Kondo, Masahide
AU - Asahi, Koichi
AU - Kurahashi, Issei
AU - Ohashi, Yasuo
AU - Watanabe, Tsuyoshi
PY - 2015/6/17
Y1 - 2015/6/17
N2 - Background: Hypertension and proteinuria are risk factors for adverse renal outcomes in patients with chronic kidney disease. This study investigated the associations of blood pressure and proteinuria on renal function in a community-based population. Methods: We analyzed data from a nationwide database of 141,514 subjects who participated in the annual "Specific Health Check and Guidance in Japan" checkup in 2008 and 2010. The study subjects were aged between 29 and 74 years, and the cohort comprised 40% men. We examined relationships between blood pressure levels, proteinuria at baseline, and the 2-year change in the estimated glomerular filtration rate (eGFR), which was determined using the Japanese equation. Results: After adjusting for possible confounders, the change in the eGFR was inversely correlated with systolic blood pressure (SBP), but not diastolic blood pressure (DBP), at baseline, irrespective of the presence of proteinuria. Compared with the lowest SBP sixtile (≤118mm Hg), eGFRs declined significantly at SBPs ≥ 134mm Hg in subjects with proteinuria, while eGFRs declined significantly at SBPs ≥ 141mm Hg in those without proteinuria. At the same SBPs, renal function decline was faster and the risk for incident renal insufficiency was higher in subjects with proteinuria compared with those without proteinuria. Conclusions: This study showed that a difference in SBP, but not DBP, is independently associated with a rapid eGFR decline in the general Japanese population, and that the association of SBP on the decline of renal function was greater in subjects with proteinuria compared with those without proteinuria.
AB - Background: Hypertension and proteinuria are risk factors for adverse renal outcomes in patients with chronic kidney disease. This study investigated the associations of blood pressure and proteinuria on renal function in a community-based population. Methods: We analyzed data from a nationwide database of 141,514 subjects who participated in the annual "Specific Health Check and Guidance in Japan" checkup in 2008 and 2010. The study subjects were aged between 29 and 74 years, and the cohort comprised 40% men. We examined relationships between blood pressure levels, proteinuria at baseline, and the 2-year change in the estimated glomerular filtration rate (eGFR), which was determined using the Japanese equation. Results: After adjusting for possible confounders, the change in the eGFR was inversely correlated with systolic blood pressure (SBP), but not diastolic blood pressure (DBP), at baseline, irrespective of the presence of proteinuria. Compared with the lowest SBP sixtile (≤118mm Hg), eGFRs declined significantly at SBPs ≥ 134mm Hg in subjects with proteinuria, while eGFRs declined significantly at SBPs ≥ 141mm Hg in those without proteinuria. At the same SBPs, renal function decline was faster and the risk for incident renal insufficiency was higher in subjects with proteinuria compared with those without proteinuria. Conclusions: This study showed that a difference in SBP, but not DBP, is independently associated with a rapid eGFR decline in the general Japanese population, and that the association of SBP on the decline of renal function was greater in subjects with proteinuria compared with those without proteinuria.
KW - blood pressure
KW - cohort study
KW - hypertension
KW - renal function
UR - http://www.scopus.com/inward/record.url?scp=84940730601&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84940730601&partnerID=8YFLogxK
U2 - 10.1093/ajh/hpv003
DO - 10.1093/ajh/hpv003
M3 - Article
C2 - 25673040
AN - SCOPUS:84940730601
VL - 28
SP - 1150
EP - 1156
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 9
ER -