Nocturnal Dipping and Kidney Function Decline: Findings From the CKD in Children Study.
Nocturnal Dipping and Kidney Function Decline: Findings From the CKD in Children Study.
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DOI：
10.1016/j.ekir.2022.08.002
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发表时间：
2022-11
影响因子：
6
通讯作者：
Ix, Joachim H.
中科院分区：
文献类型：
--
作者：
Bakhoum, Christine Y.;Phadke, Manali;Deng, Yanhong;Samuels, Joshua A.;Garimella, Pranav S.;Furth, Susan L.;Wilson, F. Perry;Ix, Joachim H.
正常情况下，血压（BP）从白天和夜间至少下降10%。在成人中，夜间钝化的尿浸与肾功能的快速下降有关。不浸尿在慢性肾脏疾病（CKD）患儿中普遍存在。我们试图确定不浸尿是否与CKD患儿蛋白尿和进展为肾衰竭有关。在前瞻性儿童CKD （CKiD）队列中，使用Cox比例风险模型来评估基线不下降与进展为肾衰竭之间的关系。采用线性混合效应模型评估不浸药与碘醇肾小球滤过率（GFR）和尿蛋白/肌酐比（log-UPCR, mg/mg）随时间变化的关系。在620名参与者中，平均年龄为11（±4）岁，平均碘醇GFR为52（±22）ml/min / 1.73 m2, 40%在基线时没有服用。在2.9年的随访期间（中位）有169例肾衰竭事件。浸尿状态与肾小球疾病患者（风险比[HR] 1.08； 95%可信区间[CI] 0.77, 1.51）或肾小球疾病患者（风险比[HR] 1.21； 95%可信区间[CI] 0.53, 2.77）或肾小球疾病患者（风险比[HR] 1.05； 95%可信区间[CI] 0.71, 1.55）肾功能衰竭总体上无显著相关性。浸渍状态不改变时间与碘醇GFR或log （UPCR）较基线变化之间的关系（交互作用P值分别为0.20和0.054）。在CKiD队列中，不浸尿与终末期肾病、GFR下降或蛋白尿变化无关。
Normally, blood pressure (BP) declines by at least 10% from daytime to nighttime. In adults, blunted nocturnal dipping has been associated with more rapid decline in kidney function. Nondipping is prevalent in children with chronic kidney disease (CKD). We sought to determine whether nondipping is associated with proteinuria and progression to kidney failure in children with CKD. In the prospective CKD in children (CKiD) cohort, Cox proportional hazards models were used to evaluate the relationship between baseline nondipping and progression to kidney failure. Linear mixed effects models were used to evaluate the relationship between nondipping and changes in iohexol glomerular filtration rate (GFR) and urine protein-to-creatinine ratio (log-UPCR, mg/mg) over time. Among 620 participants, mean age was 11 (± 4) years, mean iohexol GFR was 52 (± 22) ml/min per 1.73 m2, and 40% were nondippers at baseline. There were 169 kidney failure events during 2.9 years (median) of follow-up. Dipping status was not significantly associated with kidney failure overall (hazard ratio [HR] 1.08; 95% confidence interval [CI] 0.77, 1.51) or in those with (HR 1.21; 95% CI 0.53, 2.77) or without (HR 1.05; 95% CI 0.71, 1.55) glomerular disease. Dipping status did not modify the relationship between time and change in iohexol GFR or log (UPCR) from baseline (interaction P values = 0.20 and 0.054, respectively). Nondipping is not associated with end-stage kidney disease, GFR decline, or change in proteinuria within the CKiD cohort.
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影响因子：
12.3
作者：
Kanbay, Mehmet;Turgut, Faruk;Covic, Adrian
通讯作者：
Covic, Adrian
影响因子：
4.9
作者：
Chang, Joyce C.;Xiao, Rui;Knight, Andrea M.
通讯作者：
Knight, Andrea M.
DOI：
10.1161/hypertensionaha.111.189266
发表时间：
2012-07
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Samuels J;Ng D;Flynn JT;Mitsnefes M;Poffenbarger T;Warady BA;Furth S;Chronic Kidney Disease in Children Study Group
通讯作者：
Chronic Kidney Disease in Children Study Group
DOI：
10.1161/hypertensionaha.112.191536
发表时间：
2012-06
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Viera AJ;Lin FC;Hinderliter AL;Shimbo D;Person SD;Pletcher MJ;Jacobs DR Jr
通讯作者：
Jacobs DR Jr
影响因子：
1.6
作者：
Choi HY;Lee CJ;Lee JE;Yang HS;Kim HY;Park HC;Kim HC;Chang HJ;Park SH;Kim BS
通讯作者：
Kim BS