| Kidney function can improve in patients with hypertensive CKD. | |
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MedLine Citation:
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PMID: 22402803 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The typical assumption is that patients with CKD will have progressive nephropathy. Methodological issues, such as measurement error and regression to the mean, have made it difficult to document whether kidney function might improve in some patients. Here, we used data from 12 years of follow-up in the African American Study of Kidney Disease and Hypertension to determine whether some patients with CKD can experience a sustained improvement in GFR. We calculated estimated GFR (eGFR) based on serum creatinine measurements during both the trial and cohort phases. We defined clearly improved patients as those with positive eGFR slopes that we could not explain by random measurement variation under Bayesian mixed-effects models. Of 949 patients with at least three follow-up eGFR measurements, 31 (3.3%) demonstrated clearly positive eGFR slopes. The mean slope among these patients was +1.06 (0.12) ml/min per 1.73 m(2) per yr, compared with -2.45 (0.07) ml/min per 1.73 m(2) per yr among the remaining patients. During the trial phase, 24 (77%) of these 31 patients also had clearly positive slopes of (125)I-iothalamate-measured GFR during the trial phase. Low levels of proteinuria at baseline and randomization to the lower BP goal (mean arterial pressure ≤92 mmHg) associated with improved eGFR. In conclusion, the extended follow-up from this study provides strong evidence that kidney function can improve in some patients with hypertensive CKD. |
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Authors:
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Bo Hu; Crystal Gadegbeku; Michael S Lipkowitz; Stephen Rostand; Julia Lewis; Jackson T Wright; Lawrence J Appel; Tom Greene; Jennifer Gassman; Brad C Astor; |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2012-03-08 |
Journal Detail:
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Title: Journal of the American Society of Nephrology : JASN Volume: 23 ISSN: 1533-3450 ISO Abbreviation: J. Am. Soc. Nephrol. Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-04-02 Completed Date: 2012-05-21 Revised Date: 2013-05-20 |
Medline Journal Info:
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Nlm Unique ID: 9013836 Medline TA: J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 706-13 Citation Subset: IM |
Affiliation:
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Cleveland Clinic, Cleveland, OH 44195, USA. hub@ccf.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult African Americans / statistics & numerical data Aged Antihypertensive Agents / therapeutic use Bayes Theorem Creatinine / blood* Female Follow-Up Studies Glomerular Filtration Rate / physiology* Humans Hypertension, Renal / diagnosis*, drug therapy, ethnology Kidney Failure, Chronic / diagnosis*, ethnology Kidney Function Tests Male Middle Aged Reference Values Risk Assessment Severity of Illness Index Time Factors Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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2P20RR11104/RR/NCRR NIH HHS; 5M01 RR-00071/RR/NCRR NIH HHS; DK2818-02/DK/NIDDK NIH HHS; M01 RR-00080/RR/NCRR NIH HHS; M01 RR00827/RR/NCRR NIH HHS; M0100032//PHS HHS; M01RR00052/RR/NCRR NIH HHS; P20-RR11145/RR/NCRR NIH HHS; R01 DK090046-01/DK/NIDDK NIH HHS; U01 DK048652/DK/NIDDK NIH HHS; UL1 RR024989/RR/NCRR NIH HHS; UL1 RR024989/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 60-27-5/Creatinine |
| Comments/Corrections | |
Comment In:
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J Am Soc Nephrol. 2012 Apr;23(4):575-7
[PMID:
22402801
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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