The relationship between magnitude of proteinuria reduction and risk of end-stage renal disease - Results of the African American study of kidney disease and hypertension
The relationship between magnitude of proteinuria reduction and risk of end-stage renal disease - Results of the African American study of kidney disease and hypertension
复制标题
DOI：
10.1001/archinte.165.8.947
复制
发表时间：
2005-04-25
影响因子：
--
通讯作者：
Bakris, GL
中科院分区：
文献类型：
--
作者：
Lea, J;Greene, T;Bakris, GL
工作背景：蛋白尿的程度与进展为终末期肾病和心血管事件的风险分级增加相关。本研究的目的是将蛋白尿和肾小球滤过率（GFR）的基线和早期变化与高血压非糖尿病肾病的长期进展联系起来。方法：随机3 X 2析因试验的事后分析。共对1094名患有高血压肾病（GFR，20-65 mL/min/1.73 m2）的非洲裔美国人进行了中位3.8年的随访。参与者被随机分配到平均动脉压目标为102至107 mmHg（通常）或92 mmHg或更低（更低），并接受β受体阻滞剂（美托洛尔），血管紧张素转换酶抑制剂（雷米普利）或二氢吡啶钙通道阻滞剂（dichloropyridine calcium channel blocker）的初始治疗。结果：基线蛋白尿和GFR预测GFR下降的rgate。对于每10 mL/min，每1. 73 m（2）降低基线GFR，相关平均值+/- SE 0.38 +/- 0.08-mL/ min/1。73 m（2）每年发生更大的平均GFR下降，每2倍高蛋白尿水平，平均SE 0.54 0.05-mUmin每1。73 m2/年，观察到GFR下降更快（P
Background: The magnitude of proteinuria is associated with a graded increase in the risk of progression to end-stage renal disease and cardiovascular events. The objective of this study was to relate baseline and early changes in proteinuria and glomerular filtration rate (GFR) to long-term progression of hypertensive nondiabetic kidney disease.Methods: Post hoc analysis of a randomized 3 X 2 factorial trial. A total of 1094 African Americans with hypertensive renal disease (GFR, 20-65 mL/min per 1.73 m(2)) were followed up for a median of 3.8 years. Participants were randomized to a mean arterial pressure goal of 102 to 107 mm. Hg (usual) or 92 mm Hg or less (lower) and to initial treatment with a beta-blocker (metoprolol), an angiotensin-converting enzyme inhibitor (ramipril), or a dihydropyridine calcium channel blocker (amlodipine).Results: Baseline proteinuria and GFR predicted the rgateof GFR decline. For each 10-mL/min per 1. 73 m(2) lower baseline GFR, an associated mean +/- SE 0.38 +/- 0.08-mL/ min per 1. 73 m(2) per year greater mean GFR decline occurred, and for each 2-fold higher proteinuria level, a mean SE 0.54 0.05-mUmin per 1. 73 m(2) per year faster GFR decline was observed (P