| Renal impairment of pure autonomic failure. | |
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MedLine Citation:
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PMID: 19738158 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Supine hypertension is difficult to manage in patients with pure autonomic failure (PAF), because treatment can worsen orthostatic hypotension. Supine hypertension in PAF has been associated with left ventricular hypertrophy, but end organ damage in the kidney has not been assessed. We reviewed hemodynamic and laboratory data of 64 male patients with PAF who were 69+/-11 (mean+/-SD) years old. Systolic blood pressure fell by 67+/-40 mm Hg within 10 minutes of standing, with an inappropriately low 13+/-11-bpm increase in heart rate. Plasma norepinephrine levels were below normal (0.62+/-0.32 nmol/L supine and 1.28+/-1.25 nmol/L standing). A control data set of 75 men (67+/-12 years) was obtained from a deidentified version of the Vanderbilt University Medical Center electronic medical chart database. Compared with controls, PAF patients had lower hemoglobin (8.3+/-0.9 versus 9.3+/-0.8 mmol/L; P<0.001), packed cell volume (0.40+/-0.04 versus 0.45+/-0.04; P<0.001), and red blood cell count (4.4+/-0.5 x 10(12) versus 5.0+/-0.5 x 10(12) cells/L; P<0.001). Serum creatinine and blood urea nitrogen levels were elevated in patients. Forty-eight percent of patients with PAF had supine hypertension (supine systolic blood pressure: > or = 150 mm Hg). Serum creatinine was higher in patients with supine hypertension (133+/-44 versus 106+/-27 micromol/L; P=0.021) and estimated glomerular filtration rate was lower (57+/-22 versus 70+/-20 mL/min per 1.73 m2; P=0.022) compared with patients who did not have supine hypertension. These findings may indicate that renal function is diminished in PAF in association with supine hypertension. |
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Authors:
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Emily M Garland; Alfredo Gamboa; Luis Okamoto; Satish R Raj; Bonnie K Black; Thomas L Davis; Italo Biaggioni; David Robertson |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-09-08 |
Journal Detail:
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Title: Hypertension Volume: 54 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-22 Completed Date: 2009-11-12 Revised Date: 2013-05-31 |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
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Languages: eng Pagination: 1057-61 Citation Subset: IM |
Affiliation:
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Autonomic Dysfunction Center, Vanderbilt University, Nashville, TN 37232-2195, USA. emily.garland@vanderbilt.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Age Distribution Aged Aged, 80 and over Case-Control Studies Creatinine / blood Glomerular Filtration Rate Heart Rate / physiology Hemodynamics / physiology Humans Hypertension / complications*, diagnosis Hypotension, Orthostatic / complications*, diagnosis Incidence Male Middle Aged Norepinephrine / blood Prognosis Pure Autonomic Failure / complications*, diagnosis Reference Values Renal Insufficiency / epidemiology, etiology*, physiopathology Risk Assessment Severity of Illness Index Supine Position |
| Grant Support | |
ID/Acronym/Agency:
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K23 RR020783-04/RR/NCRR NIH HHS; KL2 RR024977/RR/NCRR NIH HHS; KL2 TR000446/TR/NCATS NIH HHS; P01 HL056693/HL/NHLBI NIH HHS; P01 HL056693-13/HL/NHLBI NIH HHS; R01 HL071784/HL/NHLBI NIH HHS; R01 HL071784-06/HL/NHLBI NIH HHS; TL1 RR024978/RR/NCRR NIH HHS; TL1 TR000447/TR/NCATS NIH HHS; UL1 RR024975/RR/NCRR NIH HHS; UL1 RR024975/RR/NCRR NIH HHS; UL1 RR024975-03/RR/NCRR NIH HHS; UL1 TR000445/TR/NCATS NIH HHS |
| Chemical | |
Reg. No./Substance:
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51-41-2/Norepinephrine; 60-27-5/Creatinine |
| Comments/Corrections | |
Comment In:
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Kidney Int. 2010 Jan;77(2):81-2
[PMID:
20050379
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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