Blood Pressure, CKD Progression, and Kidney Allograft Failure in Kidney Transplant Recipients: A Secondary Analysis of the FAVORIT Trial.

Blood Pressure, CKD Progression, and Kidney Allograft Failure in Kidney Transplant Recipients: A Secondary Analysis of the FAVORIT Trial. Am J Hypertens. 2019 Jun 08;: Authors: Malhotra R, Katz R, Weiner DE, Levey AS, Cheung AK, Bostom A, Ix JH Abstract BACKGROUND: In chronic kidney disease (CKD), intensive systolic blood pressure (SBP) control reduces mortality at a cost of greater acute kidney injury (AKI) risk. Kidney transplantation involves implantation of denervated kidneys and immunosuppressive medications that increase AKI risk. The optimal blood pressure (BP) target in kidney transplant recipients (KTRs) is uncertain. Prior observational studies from the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) trial demonstrate associations of lower SBP levels and reduced mortality risk, but the relationship of BP with kidney allograft function remains unknown. Thus, in FAVORIT, we investigated the relationship of SBP and diastolic blood pressure (DBP) with risk of kidney allograft failure and estimated glomerular filtration rate (eGFR) slope among stable KTRs. METHODS: Cox proportional hazards and multivariable linear regression models adjusted for demographics, transplant characteristics, comorbidities, baseline eGFR, and urine albumin-to-creatinine ratio were used to determine associations of SBP and DBP with time to a composite kidney outcome of ≥50% eGFR decline or dialysis dependence, and with annualized eGFR change, ...
Source: American Journal of Hypertension - Category: Cardiology Authors: Tags: Am J Hypertens Source Type: research

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The management of hypertension in renal disease is best understood by classifying patients according to the stage of their chronic kidney disease (CKD). Many of the pathophysiological mechanisms are common to all patients, but in post-transplant recipients there are additional factors to be considered. The benefits of good blood pressure control in CKD are a slowing in the rate of progression of renal disease and a reduction in cardiovascular morbidity and all-cause mortality. In CKD stage 5, the aim is solely to reduce cardiovascular morbidity and mortality; the evidence of benefit here is more controversial, with several...
Source: Medicine - Category: Internal Medicine Authors: Tags: Hypertension and renal disease Source Type: research
Abstract Intervention for higher-risk participants of health checkups especially with diabetes has been started in Japan to prevent renal replacement therapy (RRT) initiation, but evidence about RRT initiation risk among checkup participants has been scarce. To estimate the incidence by risk factors, we conducted a retrospective cohort study using medical claims and checkup data of a community-based insurance scheme in Japan. Beneficiaries who participated in the checkup in 2012-2013 were included and followed up for about five years. We estimated the incidence of RRT initiation by the subject characteristics, fol...
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
Kidney transplantation (KT) is the treatment of choice for end stage kidney disease , offering the highest survival benefit amongst all the different renal replacement therapies1. Long term renal allograft and patient survival have shown substantial improvements over time: however, death with a functioning allograft remains the leading cause of late allograft loss with cardiovascular disease (CVD) related deaths representing a major cause of mortality2. While recipients of kidney transplants have lower risk for CVD when compared to the 10-20 fold increased risk in patients with dialysis, their risk of CVD is substantially ...
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Policy Forum Source Type: research
Purpose of review Hypertension (HTN) and chronic kidney disease (CKD) are significant problems. With recent advances in technologies, biosensors have shown a great potential to provide better home monitoring in hypertension (HTN), medication compliance, diagnostic device for kidney disease, CKD/end-stage renal disease (ESRD) care, and post kidney transplant management. Recent findings Multiple devices/biosensors have been developed related to HTN, kidney function including real-time glomerular filtration rate, CKD/end-stage renal disease, and transplant care. In recent advances in wearable biosensors, point of care mo...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: RENAL PATHOPHYSIOLOGY: Edited by Orson W. Moe and Susan E. Quaggin Source Type: research
Conclusion: Reduction of aortic stiffness index β0 3 months after KTx suggests that KTx leads to an early de-stiffening of the intrinsic mechanical properties of aorta. However, this improvement is followed by a later stiffening, which is associated with increased interleukin-6, suggesting that activation of the immune system may be involved in arterial wall remodelling in kidney recipients.
Source: Journal of Hypertension - Category: Cardiology Tags: ORIGINAL PAPERS: Treatment Source Type: research
CONCLUSIONS: The majority of T2D patients with CKD had a high level of knowledge, but weaknesses were observed in the self-management of CKD and clinic attendance. This information should be considered by clinicians and policy-makers to improve management and treatment of CKD in T2D. PMID: 31132078 [PubMed - in process]
Source: Review of Diabetic Studies - Category: Endocrinology Tags: Rev Diabet Stud Source Type: research
I seem to have lost track of advancements in dipstick technology understanding that it is well established in such areas as pregnancy testing. Home glucose testing for diabetics, of course, is growing increasingly sophisticated with the test strips beingread by a meter. A recent article indicated that this meter technology can be replaced by the camera in a smartphone for recording and analyzing dipstick color changes when screening for kidney disease (see:FDA approves smartphone camera –based dipstick product). Below is an excerpt from the article: Healthy.io, based in Tel Aviv, Israel, has obtained U...
Source: Lab Soft News - Category: Laboratory Medicine Authors: Tags: Clinical Lab Industry News Clinical Lab Testing Diagnostics Food and Drug Administration Healthcare Information Technology Healthcare Innovations Lab Industry Trends Lab Processes and Procedures Medical Consumerism Medical Research Poi Source Type: blogs
This study aimed to find out the prevalence of asymptomatic persistent proteinuria in adolescent students. This was a multi-assessment study. Screening for proteinuria was conducted on five junior high schools across Jakarta, Indonesia, in April-June 2015. Healthy students aged 12-14 years whose parents provided informed consent were selected randomly. Urine collections were performed thrice. We used dipstick tests and protein-to-creatinine ratio to measure protein in the urine. From 536 students, 485 were eligible and recruited for this study. They were more female and well-nourished students. Hypertension constituted 12....
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Abstract Obesity is a recognized worldwide epidemic with increasing prevalence in developing nations. Studies have shown that obesity is an independent risk factor for the development of chronic kidney disease (CKD) besides its link with diabetes mellitus and hypertension. We evaluated the renal status of obese patients using both the established [creatinine (Cr)] and new (cystatin C) markers of renal function. This was a cross-sectional study. Fifty-nine consenting adults attending the clinic for routine medical checks were recruited for this study. They were divided into obese and non-obese based on their body m...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Najmi Diabetes and hypertension are the two major causes of chronic kidney disease (CKD). Epidemiological studies have found poor knowledge about the CKD among the general population. Hence, this study aimed to assess the awareness of CKD among type 2 diabetes mellitus (T2DM) patients in India. Patients with confirmed T2DM were included in the study. Patients receiving dialysis or with a history of a kidney transplant were excluded. A validated questionnaire was used to assess knowledge about CKD. Demographic characteristics were presented using descriptive statistics and trends in groups were calculated using the chi-...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
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