Cross-classification by systolic and diastolic blood pressure levels and chronic kidney disease, proteinuria, or kidney function decline
Cross-classification by systolic and diastolic blood pressure levels and chronic kidney disease, proteinuria, or kidney function decline
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按收缩压和舒张压水平与慢性肾脏病、蛋白尿或肾功能下降进行交叉分类
DOI：
10.1038/s41440-023-01267-1
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发表时间：
2023
影响因子：
5.4
通讯作者：
Metoki Hirohito
中科院分区：
文献类型：
--
作者：
Suenaga Tsukasa;Satoh Michihiro;Murakami Takahisa;Hirose Takuo;Obara Taku;Nakayama Shingo;Hashimoto Hideaki;Toyama Maya;Muroya Tomoko;Kanno Atsuhiro;Mori Takefumi;Ohkubo Takayoshi;Imai Yutaka;Metoki Hirohito
通过血压（BP）测量预测和预防新发慢性肾脏病（CKD）是值得的。本研究评估了慢性肾病的风险，根据收缩压和舒张压（SBP和DBP）的交叉分类，慢性肾病的风险定义为蛋白尿和/或估计的肾小球滤过率（eGFR）<60 mL/min/1.73 m2。这项基于人群的回顾性队列研究分析了JMDC数据库中1，492，291名无CKD且未接受抗高血压治疗的参与者的数据，该数据库包含日本年龄<75岁的年度健康检查数据。在平均3.2年的随访中，CKD发病率、蛋白尿和eGFR <60 mL/min/1.73 m2分别发生在92，587、67，021和28，858名参与者中。以收缩压/舒张压<120/<80 mmHg为参照组，高收缩压和高舒张压均与CKD风险增加显著相关。与SBP相比，DBP与CKD风险的相关性更强; SBP/DBP为130-139/≥90 mmHg组的CKD风险比为1.44-1.80，SBP/DBP ≥140/80-89 mmHg组的风险比为1.23-1.47。对于发生蛋白尿和eGFR <60 mL/min/1.73 m2，观察到类似的结果。SBP/DBP ≥150/<80 mmHg与CKD风险升高密切相关，因为eGFR下降的风险增加。高血压，特别是孤立的高DBP水平，是无肾脏疾病的中年人中CKD的重要危险因素。此外，应注意肾功能，特别是eGFR下降，在低DBP和极高SBP水平的情况下。
Predicting and preventing new-onset chronic kidney disease (CKD) through blood pressure (BP) measurements is worthwhile. This study assessed the risk of CKD, which was defined as proteinuria and/or an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, according to cross-classification by systolic and diastolic BP (SBP and DBP). This retrospective population-based cohort study analyzed data from 1,492,291 participants without CKD and without antihypertensive treatment in the JMDC database, which contains the annual health check-up data of Japanese aged <75 years. During a mean follow-up of 3.2 years, CKD incidence, proteinuria, and eGFR <60 mL/min/1.73 m2occurred in 92,587, 67,021, and 28,858 participants, respectively. When the SBP/DBP <120/<80 mmHg group was set as a reference, both high SBP and DBP were significantly associated with an elevated CKD risk. DBP tended to be more strongly associated with CKD risk than SBP; the hazard ratio of CKD was 1.44–1.80 in the group with SBP/DBP of 130–139/≥90 mmHg and 1.23–1.47 in the group with SBP/DBP of ≥140/80–89 mmHg. A similar result was observed for developing proteinuria and eGFR <60 mL/min/1.73 m2. SBP/DBP ≥150/<80 mmHg was strongly associated with an elevated CKD risk due to the increased risk of eGFR decline. High BP, especially isolated high DBP levels, is a significant risk factor for CKD among individuals around middle age without kidney disease. Moreover, attention should be paid to kidney function, particularly eGFR decline, in the case of low DBP with extremely high SBP levels.
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影响因子：
8.3
作者：
Arima, Hisatomi;Murakami, Yoshitaka;Woodward, Mark
通讯作者：
Woodward, Mark
影响因子：
158.5
作者：
Flint, Alexander C.;Conell, Carol;Bhatt, Deepak L.
通讯作者：
Bhatt, Deepak L.
影响因子：
5.3
作者：
S. Nakayama;M. Satoh;Y. Tatsumi;T. Murakami;Tomoko Muroya;T. Hirose;T. Ohkubo;Takefumi Mori;A. Hozawa;H. Metoki
通讯作者：
S. Nakayama;M. Satoh;Y. Tatsumi;T. Murakami;Tomoko Muroya;T. Hirose;T. Ohkubo;Takefumi Mori;A. Hozawa;H. Metoki
影响因子：
158.5
作者：
Klag, MJ;Whelton, PK;Stamler, J
通讯作者：
Stamler, J
影响因子：
3.2
作者：
Fukushima, Ayako;Khabtheni, Wafa;Toumi, Mondher
通讯作者：
Toumi, Mondher