Document Detail


The independent relationship between creatinine clearance, microalbuminuria and circadian blood pressure levels in newly diagnosed essential hypertensive and type 2 diabetic patients.
MedLine Citation:
PMID:  22795337     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Increased evidence suggests that apart from patients with increased albumin excretion and decreased glomerular filtration rate (GFR); there are also patients with type 2 diabetes with decreased GFR but without albuminuria. The exact pathophysiologic mechanisms regarding these clinical conditions are not known. We suggest that different blood pressure (BP) levels may be one the factors for these different clinical conditions. However, before labeling BP as a causative factor; one must show whether BP levels are different in these patients. Thus the current study was performed to analyze the relationship between creatinine clearance, microalbuminuria and circadian blood pressure levels in newly diagnosed essential hypertensive and type 2 diabetic patients.
METHODS: Medical history, physical examination, laboratory analysis and ambulatory blood pressure measurements (ABPMs) were analyzed. 24-h urine specimens were collected to measure creatinine clearance and albumin excretion
RESULTS: In total 216 patients were included which were divided into 4 groups: group 1 composed of 90 patients with normal GFR and without microalbuminuria (MA), group 2 composed of 50 patients with normal GFR and with MA, group 3 composed of 36 patients with decreased GFR and without MA and group 4 composed of 40 patients with both decreased GFR and MA. The ratio of dippers vs. non dippers was not different between group 1, group 2 and group 3 patients. However ratio of dippers was higher in group 1 when compared to group 4 (P: 0.003) and group 4 patients have an odds of 7.678 (CI: 1.657-35.576, P: 0.009) for non-dapping status when compared to patients in group 1.
CONCLUSION: In conclusion, ABPM measurements were highest in patients with both decreased GFR and MA, whereas they are lowest in patients with normal GFR and normal UAE.
Authors:
Baris Afsar; Rengin Elsurer
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Publication Detail:
Type:  Journal Article     Date:  2012-07-12
Journal Detail:
Title:  Journal of diabetes and its complications     Volume:  26     ISSN:  1873-460X     ISO Abbreviation:  J. Diabetes Complicat.     Publication Date:    2012 Nov-Dec
Date Detail:
Created Date:  2012-11-12     Completed Date:  2013-04-22     Revised Date:  2013-09-10    
Medline Journal Info:
Nlm Unique ID:  9204583     Medline TA:  J Diabetes Complications     Country:  United States    
Other Details:
Languages:  eng     Pagination:  531-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Nephrology, Zonguldak Atatürk State Hospital, Zonguldak, Turkey. afsarbrs@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Albuminuria / etiology*,  physiopathology
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm
Cross-Sectional Studies
Diabetes Mellitus, Type 2 / complications*,  physiopathology,  urine
Diabetic Nephropathies / epidemiology,  physiopathology*,  urine
Female
Glomerular Filtration Rate
Humans
Hypertension / complications*,  epidemiology,  physiopathology,  urine
Kidney / physiopathology
Male
Middle Aged
Renal Insufficiency / etiology*
Risk Factors
Severity of Illness Index
Turkey / epidemiology

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