Association between initial systolic blood pressure and risk of developing a uremic crisis or of dying in dogs with chronic renal failure
Association between initial systolic blood pressure and risk of developing a uremic crisis or of dying in dogs with chronic renal failure
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DOI：
10.2460/javma.2003.222.322
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发表时间：
2003-02-01
期刊：
影响因子：
--
通讯作者：
Swanson, LL
中科院分区：
文献类型：
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作者：
Jacob, F;Polzin, DJ;Swanson, LL
目的：确定犬慢性肾功能衰竭初始诊断时的高收缩压（SBP）是否与尿毒症危象风险、死亡风险或肾功能下降率增加相关。设计-前瞻性队列研究。动物-45只自发性慢性肾功能衰竭犬。程序-根据初始SBP将犬分配至3组中的1组采用Kaplan-Meier和考克斯比例风险法评估SBP与尿毒症危象和死亡之间的关系。血清肌酐浓度的倒数被用来作为估计的肾function.Results-Dogs在高SBP组更容易发展成尿毒症危象和死亡比其他组的狗，和发展成尿毒症危象和死亡的风险显着增加SBP增加。在高SBP组的犬中观察到肾功能下降幅度更大。14只SBP ≥ 180 mm Hg的犬中有3只出现视网膜病变和高血压性脑病。11只犬中有10只接受了抗高血压药物治疗，收缩压仍然很高，结论和临床相关性结果表明，慢性肾功能衰竭犬的初始高收缩压与尿毒症危象和死亡风险增加有关。需要进一步的研究来确定高SBP和进行性肾损伤之间是否存在因果关系，并确定降压药物治疗的风险和获益。
Objective-To determine whether high systolic blood pressure (SBP) at the time of initial diagnosis of chronic renal failure in dogs was associated with increased risk of uremic crisis, risk of dying, or rate of decline in renal function.Design-Prospective cohort study.Animals-45 dogs with spontaneous chronic renal failure.Procedure-Dogs were assigned to 1 of 3 groups on the basis of initial SBP (high, intermediate, low); Kaplan-Meier and Cox proportional hazards methods were used to estimate the association between SBP and development of a uremic crisis and death. The reciprocal of serum creatinine concentration was used as an estimate of renal function.Results-Dogs in the high SBP group were more likely to develop a uremic crisis and to die than were dogs in the other groups, and the risks of developing a uremic crisis and of dying increased significantly as SBP increased. A greater decrease in renal function was observed in dogs in the high SBP group. Retinopathy and hypertensive encephalopathy were detected in 3 of 14 dogs with SBP greater than or equal to 180 mm Hg. Systolic blood pressure remained high in 10 of 11 dogs treated with antihypertensive drugs.Conclusions and Clinical Relevance-Results suggested that initial high SBP in dogs with chronic renal failure was associated with increased risk of developing a uremic crisis and of dying. Further studies are required to determine whether there is a cause-and-effect relationship between high SBP and progressive renal injury and to identify the risks and benefits of antihypertensive drug treatment.