Long-term blood pressure variability and development of chronic kidney disease in type 2 diabetes

Objective: Long-term visit-to-visit SBP variability (VVV) has been shown to predict cerebro-cardiovascular events and end-stage renal disease in chronic kidney disease (CKD) patients. Whether SBP VVV is also a predictor of CKD development in diabetes is currently uncertain. We assessed the role of SBP VVV on the development of CKD in patients with type 2 diabetes (T2D) and hypertension in real life. Methods: Clinical records from 30 851 patients with T2D and hypertension, with normal estimated glomerular filtration rate (eGFR) and regular visits during a 4-year follow-up were analyzed. SBP variability was measured by three metrics: coefficient of variation; SD of the mean SBP and average absolute difference of successive values in each individual. CKD was defined as eGFR less than 60 and/or a reduction in eGFR at least 30% from baseline. Results: Over the 4-year follow-up, 9.7% developed eGFR less than 60 and 4.5% an eGFR reduction at least 30% from baseline. Several clinical characteristics (older age, male sex, SBP, DBP, albuminuria, glycated hemoglobin, insulin treatment) were related to intraindividual SBP variability. Patients with VVV in the upper quintile showed an increased risk of developing both components of CKD [adjusted odds ratio (OR) 1.21, P 
Source: Journal of Hypertension - Category: Cardiology Tags: ORIGINAL PAPERS: Kidney Source Type: research

Related Links:

AbstractThe World Health Organization defines overweight and obesity as the condition where excess or abnormal fat accumulation increases risks to health. The prevalence of obesity is increasing worldwide and is around 20% in ICU patients. Adipose tissue is highly metabolically active, and especially visceral adipose tissue has a deleterious adipocyte secretory profile resulting in insulin resistance and a chronic low-grade inflammatory and procoagulant state. Obesity is strongly linked with chronic diseases such as type 2 diabetes, hypertension, cardiovascular diseases, dyslipidemia, non-alcoholic fatty liver disease, chr...
Source: Intensive Care Medicine - Category: Intensive Care Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
RAGE is the receptor for advanced glycation end-products (AGEs), the mechanism by which cells react to the presence of AGEs. AGEs are metabolic byproducts that are both created in the body and present in the diet; cooking animal fat produces AGEs, for example. Diets heavy in meat and the related, fun, unhealthy products so prevalent in this modern calorie-packed world of ours are also heavy in AGEs of various sorts. It remains a topic for discussion as to the degree to which dietary AGEs are a problem, however. Do they contribute significantly to the issues caused by AGEs in general, or only in conditions in which metaboli...
Source: Fight Aging! - Category: Research Authors: Tags: Medicine, Biotech, Research Source Type: blogs
This is a case report of a man in his 60s with stage 3 chronic kidney disease, hypertension, hyperlipidemia, type 2 diabetes, bladder and kidney cancer, and depression who underwent hypoglossal nerve stimulator implantation and subsequently demonstrated a Cheyne-Stokes breathing pattern.
Source: JAMA Otolaryngology - Head and Neck Surgery - Category: ENT & OMF Source Type: research
Abstract AIM: - Evidence is emerging that PNPLA3 rs738409 polymorphism (the major genetic variant associated with susceptibility to non-alcoholic fatty liver disease [NAFLD]) is associated with chronic kidney disease (CKD) in non-diabetic individuals. Currently, little is known about this association in type 2 diabetic (T2DM) patients with and without NAFLD. METHODS: - We studied 101 Caucasian post-menopausal women with T2DM, consecutively attending our diabetes outpatient service during a 3-month period. Glomerular filtration rate (eGFRCKD-EPI) was estimated using the CKD-Epidemiology Collaboration equation,...
Source: Diabetes and Metabolism - Category: Endocrinology Authors: Tags: Diabetes Metab Source Type: research
The objective of the study was to explore trial of labor and its failure in pregnancies with medical risk conditions, in a population with a high trial of labor rate.Material and methodsIn a cohort study (n=57  109), using data from the Medical Birth Registry of Norway 1989‐2014, women with a second delivery after a first pregnancy cesarean section were included. Preterm, multiple, and non‐cephalic deliveries were excluded. The outcomes were trial of labor and failed trial of labor, assessed as rates and relative risk, using deliveries without risk conditions as reference. Temporal trends were assessed by three‐...
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: Original Research Article Source Type: research
A 66-year-old white man with a medical history of chronic kidney disease (CKD) stage 3a (baseline creatinine level of 1.4 mg/dL; normal 0.74-1.35 mg/dL) with an estimated glomerular filtration rate of 52 mL/min per 1.73 m2 per the Chronic Kidney Disease Epidemiology collaboration equation, controlled type 2 diabetes mellitus with microalbuminuria, hypertension, hyperlipidemia, and medically complicated obesity (body mass index, 37) presented to his primary care clinic with episodes of orthostatic light-headedness that had been occurring for approximately 2 weeks.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents' clinic Source Type: research
The objective of this study was to estimate the population attributable fractions (PAFs) of preventable or modifiable HIV-related and traditional risk factors for non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes.MethodsWe included participants receiving care in academic and community-based outpatient HIV clinical cohorts in the USA and Canada from Jan 1, 2000, to Dec 31, 2014, who contributed to the North American AIDS Cohort Collaboration on Research and Design and who had validated non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, or ...
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research
This patient was a 57-year-old African-American man with past medical history of chronic kidney disease, insulin-dependent diabetes type 2, and hypertension, who presented to the emergency department with complaints of uncontrolled right arm movement ongoing for three days prior to admission. He reported waking up one morning with his arm making involentary circular motions which he was unable to stop. He reported this had never happened in the past. When asked, he noted no injury or trauma that led up to this event, was not currently on any antipsychotic medications, and had no history or family history of movement disorders.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Images in Radiology Source Type: research
Obesity is the global epidemic of the 21st century: about 1.5 billion adults worldwide are overweight, and among them, about 200 million men and 300 million women are obese [1]. In some countries, the prevalence of obesity has exceeded 50%, as in Tonga (men), and in Kuwait, Kiribati, Micronesia, Libya, Qatar, Tonga and Samoa (women) [2]. The prevalence of overweight and obesity are also increasing in children and adolescents in developed (about 25%) and in developing countries (about 13%) [2]. Obesity has been associated with many comorbidities, including type 2 diabetes mellitus (T2DM), nonalcoholic fatty liver disease (N...
Source: Metabolism - Clinical and Experimental - Category: Biomedical Science Authors: Source Type: research
More News: Cardiology | Cardiovascular | Chronic Kidney Disease | Diabetes | Diabetes Type 2 | Endocrinology | Heart | Hypertension | Insulin | Urology & Nephrology