Amplified Association Between Blood Pressure and Albuminuria in Overweight Patients With Biopsy-Proven Hypertensive Nephrosclerosis.
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Kohagura Kentaro, Furuichi Kengo, Kochi Masako, Shimizu Miho, Yuzawa Yukio, Hara Akinori, Toyama Tadashi, Kitamura Hiroshi, Suzuki Yoshiki, Sato Hiroshi, Uesugi Noriko, Ubara Yoshifumi, Hoshino Junichi, Hisano Satoshi, Ueda Yoshihiko, Nishi Shinichi, Yokoyama Hitoshi, Nishino Tomoya, Ogawa Daisuke, Mise Koki, Shibagaki Yugo, Kimura Kenjiro, Haneda Masakazu, Makino Hirofumi, Matsuo Seiichi, Wada Takashi, Research Group of Diabetic Nephropathy and Nephrosclerosis, Ministry of Health, Labour and Welfare of Japan, and Japan Agency for Medical Research and Development
Аннотация
METHODS: A total of 97 patients with biopsy-confirmed hypertensive nephrosclerosis were recruited from 13 centers throughout Japan. We examined the relationship between SBP and proteinuria among those who were overweight, which is defined as a body mass index ≥25 kg/m2, and those who were not. We examined the interaction of weight and SBP with albuminuria at baseline and with the changes in estimated glomerular filtration rate (eGFR) during the observational period.
RESULTS: Our results included mean age (54 years old), blood pressure (138/80), eGFR (53 ml/min/1.73 m2), and urine albumin levels (0.2 g/day). SBP was significantly correlated with log-transformed urine albumin levels (r = 0.4, P = 0.01) in patients who were overweight (n = 38) compared with patients who were not overweight (n = 59). Multiple regression analysis revealed that the interaction between being overweight and SBP with respect to albuminuria was significantly correlated with the log-transformed urine albumin level (β = 0.39, P = 0.047) and was independent of age, sex, and potential confounding factors. The interaction between weight and SBP ≥140 mm Hg was significantly associated with a greater decrease in eGFR in the following 3 years.
CONCLUSIONS: Being overweight may enhance susceptibility to hypertensive glomerular damage and may eventually lead to renal progression in patients with hypertensive nephrosclerosis.