Abstract:
RATIONALE AND OBJECTIVE:In the Systolic Blood Pressure Intervention Trial, the possible relationships between acute kidney injury (AKI) and risk of major cardiovascular events and death are not known. STUDY DESIGN:Post hoc analysis of a multicenter, randomized, controlled, open-label clinical trial. SETTING AND PARTICIPANTS:Hypertensive adults without diabetes who were ≥50 years of age with prior cardiovascular disease, chronic kidney disease (CKD), 10-year Framingham risk score > 15%, or age > 75 years were assigned to a systolic blood pressure target of < 120 mm Hg (intensive) or < 140 mm Hg (standard). PREDICTOR:AKI episodes. OUTCOMES:The primary outcome was a composite of myocardial infarction, acute coronary syndrome, stroke, decompensated heart failure, or cardiovascular death. The secondary outcome was death from any cause. Analytical Approach: AKI was defined using the Kidney Disease: Improving Global Outcomes modified criteria based solely upon serum creatinine. AKI episodes were identified by serious adverse events or emergency room visits. Cox proportional hazards models assessed the risk for the primary and secondary outcomes by AKI status. RESULTS:Participants were 68 ± 9 years of age, 36% women (3,332/9,361), and 30% Black race (2,802/9,361), and 17% (1,562/9,361) with cardiovascular disease. Systolic blood pressure was 140 ± 16 mm Hg at study entry. AKI occurred in 4.4% (204/4,678) and 2.6% (120/4,683) in the intensive and standard treatment groups respectively (p < 0.001). Those who experienced AKI had higher risk of cardiovascular events (hazard ratio [HR] 1.52, 95% CI 1.05-2.20, p = 0.026) and death from any cause (HR 2.33, 95% CI 1.56-3.48, p < 0.001) controlling for age, sex, race, baseline systolic blood pressure, body mass index, number of antihypertensive medications, cardiovascular disease and CKD status, hypotensive episodes, and treatment assignment. LIMITATIONS:The study was not prospectively designed to determine relationships between AKI, cardiovascular events, and death. CONCLUSIONS:Among older adults with hypertension at high cardiovascular risk, intensive treatment of blood pressure independently increased risk of AKI, which substantially raised risks of major cardiovascular events and death.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Dieter BP,Daratha KB,McPherson SM,Short R,Alicic RZ,Tuttle KRdoi
10.1159/000499574subject
Has Abstractpub_date
2019-01-01 00:00:00pages
359-367issue
5eissn
0250-8095issn
1421-9670pii
000499574journal_volume
49pub_type
杂志文章,多中心研究,随机对照试验abstract::There is still debate as to the preferred extracorporeal treatment modality for severe lithium intoxication. Because lithium is readily diffusable, intermittent hemodialysis is usually performed. However, this bares the risk of a post-dialysis rebound concentration and, in the case of severe lithium poisoning collapse...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013627
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Clinical indicators for accurately distinguishing diabetic nephropathy (DN) from non-diabetic renal disease in type 2 diabetes (T2D) are lacking. This study aimed to develop and validate a nomogram for predicting DN in T2D patients with kidney disease. METHODS:A total of 302 consecutive patients with T2D wh...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000505145
更新日期:2020-01-01 00:00:00
abstract::The medical history of salt begins in ancient times and is closely related to different aspects of human history. Salt may be extracted from sea water, mineral deposits, surface encrustations, saline lakes and brine springs. In many inland areas, wood was used as a fuel source for evaporation of brine and this practic...
journal_title:American journal of nephrology
pub_type: 历史文章,杂志文章
doi:10.1159/000168759
更新日期:1994-01-01 00:00:00
abstract::The prejunctional beta-adrenoceptors present in the isolated perfused kidney of normotensive rats (NR) and spontaneously hypertensive rats (SHR) were compared and the effects of tertatolol on these receptors were investigated. Kidneys of NR (Wistar + Wistar-Kyoto [WKY]) and SHR, were continuously perfused with Tyrode ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167330
更新日期:1986-01-01 00:00:00
abstract::The treatment of the bleeding diathesis of renal failure remains unsatisfactory. 1-Deamino-8-D-arginine vasopressin (DDAVP) has recently been shown to shorten the prolonged bleeding time of renal failure and may as a result diminish the risk of clinical hemorrhage. We describe 2 cases where DDAVP was used successfully...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166773
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND/AIM:Although clinical and immunological findings in steroid-sensitive nephrotic syndrome (SSNS) favor an immunopathogenesis, many issues remain unsolved. Comprehensive studies analyzing cellular and humoral immunity in SSNS are scarce, and few studies addressed the effect of steroids on immunological factors...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000085357
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Transglutaminase 2 (TGM2) is a calcium-dependent enzyme that can cross-link nearly all extracellular matrix (ECM) proteins and can facilitate cell-ECM interaction through integrins. Given the importance of the ECM in vascular calcification we tested the hypothesis that increased TGM2 activity may accelerate ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000347031
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:We hypothesized that the difference between the prescribed end-dialysis body weight, defined end-dialysis over-weight (edOW; kg), and the body weight which is actually attained could impact survival in hemodialysis (HD) patients. The aim of this prospective observational study was to evaluate if edOW could i...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000349931
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Steroid therapy has become an effective option for patients with primary Sjogren's syndrome with tubulointerstitial nephritis (TIN), while the use of cytotoxic agents is still debated. Our study aimed to compare the clinical outcomes of patients treated with cyclophosphamide (CTX) combined with glucocorticoi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000484903
更新日期:2017-01-01 00:00:00
abstract::Therapeutic use of D-penicillamine has been associated with a range of adverse effects. We present a patient with scleroderma, treated with D-penicillamine for 5 years, who developed severe renal failure due to rapidly progressive glomerulonephritis with both crescents and subepithelial immune deposits on renal biopsy...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000169183
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Nephrology research is expanding, and harnessing the much-needed information and data for the practice of evidence-based medicine is becoming more challenging. In this study, we used the natural language processing and text mining approach to mitigate some of these challenges. METHODS:We analyzed 17,412 abs...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000504871
更新日期:2020-01-01 00:00:00
abstract::Serum levels of soluble interleukin-2 receptors (IL2R) and of beta 2-microglobulin (beta 2M) were studied with the immunoenzymatic technique in 38 patients with primary glomerulonephritis (GN), in 10 patients with essential hypertension (EH) and in 30 healthy subjects. IL2R correlated with beta 2M (p < 0.05). IL2R and...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168627
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND/AIM:Slc26a6 (PAT1, CFEX) is a major chloride/base exchanger located on the apical membrane of the kidney proximal tubule. The purpose of the present study was to examine the effect of Slc26a6 deletion on the apical Na+/H+ exchanger 3 (NHE3) in the straight segment (S3) of the proximal tubule, which is the ma...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000111826
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND/AIMS:Anthropometric measures such as body mass index (BMI) and waist circumference (WC) have differential associations with incident chronic kidney disease (CKD) and mortality. We examined the associations of BMI and WC with various CKD complications. METHODS:We conducted a cross-sectional analysis of 2,853...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000341862
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/AIMS:Vitamin D insufficiency drives secondary hyperparathyroidism (SHPT) and is associated with increased cardiovascular mortality in patients with chronic kidney disease (CKD). SHPT is poorly addressed by current vitamin D repletion options. The present study evaluated a novel investigational vitamin D repl...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000369939
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Treatment of metabolic acidosis to target the higher serum bicarbonate level than guideline recommendation may downregulate muscle protein degradation and improve renal function among chronic kidney disease (CKD) patients. We conducted a study to test the effects of increased serum bicarbonate level on muscl...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000504557
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND/AIMS:Gastrointestinal (GI) symptoms in renal transplant recipients may be caused due to mycophenolic acid (MPA) toxicity. Using small bowel capsule endoscopy (SBCE) we examined the impact of conversion from Mycophenolate Mofetil (MMF) to enteric-coated formulation of Mycophenolate Sodium (EC-MPS) given to tr...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000365360
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND/AIMS:Evaluation of the risk factors, and phenotype-genotype correlation of familial Mediterranean fever (FMF) gene (MEFV) and serum amyloid A1 (SAA1) gene polymorphisms in renal amyloidosis. METHODS:We investigated MEFV and SAA1 genotypes (alpha, beta, and gamma isoforms) in 50 FMF patients and 50 healthy c...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000087824
更新日期:2005-09-01 00:00:00
abstract::Radioisotopic methods for the determination of the glomerular filtration rate (GFR) are highly accurate but require the collection of multiple blood and urine samples and are costly to perform due to personnel, material, and analysis costs. Nonradioactive methods of GFR determination have the potential of minimizing p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168985
更新日期:1996-01-01 00:00:00
abstract::Heavy proteinuria in patients with essential hypertension raises the question of underlying primary renal disease. While malignant hypertension may be associated with proteinuria in the nephrotic range, it is generally held that protein excretion in benign nephrosclerosis is almost invariably less than 0.5-1.0 g/24 h....
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166931
更新日期:1985-01-01 00:00:00
abstract::A 22-year-old woman presented glomerulonephritis with Schönlein-Henoch-like syndrome and monoclonal abnormality. One month later, she developed a rapidly progressive glomerulonephritis with hypertension and persistent purpura. In the two renal biopsies performed during the first and the second attack, mesangial expans...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168276
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Serum creatinine (SCr) levels are decreased following traumatic amputation, leading to the overestimation of glomerular filtration rate (GFR). β-Trace protein (BTP) and β2-microglobulin (B2M) strongly correlate with measured GFR and have not been studied following amputation. We hypothesized that BTP and B2M...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000443775
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:To evaluate the association of dialysate interleukin-6 (IL-6), a marker of ongoing peritoneal inflammation, with the alteration of peritoneal solute transport rate (PSTR) in continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS:Stable CAPD patients were enrolled in the present study. A total of...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000362622
更新日期:2014-01-01 00:00:00
abstract::Renal function and life expectancy can be improved by aggressive antihypertensive therapy in severe hypertension. However, most reports of severe hypertension and renal failure concern primary hypertensive states. 3 cases of primary renal disease, 1 glomerular, 1 obstructive and 1 of chronic pyelonephritis, are descri...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166576
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) occurs frequently in the intensive care unit. A primary cause is renal ischemia/reperfusion (I/R) injury, during which excess reactive oxygen species (ROS) are produced. ROS subsequently damage renal cells, leading to the development of AKI. Here, we investigated whether renal I/R i...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000327820
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Previous studies on end-of-life (EOL) care among patients with chronic kidney disease (CKD) have been largely limited to White hemodialysis patients. In this study, we sought to explore racial variability in EOL communication, care preferences and advance care planning (ACP) among patients with advanced CKD ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000447097
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics. METHODS:Arterial vascular properties were qua...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000110091
更新日期:2008-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000086080
更新日期:2005-05-01 00:00:00
abstract::Ion-selective electrodes have been designed for determining the ionized concentration of magnesium in blood, the biologically active form of this ion. The effect of acute acidosis induced by ammonium loading on circulating and urinary magnesium was investigated in 11 volunteers. No changes in plasma total and ionized ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013342
更新日期:1998-01-01 00:00:00
abstract:AIM:The relation of ambient temperature (AMT) and relative humidity to systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight (BW), and body weight gain between dialysis sessions (DeltaBW) was examined in hemodialysis patients by Fourier analysis. METHODS AND RESULTS:The authors recruited 144 dialy...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013538
更新日期:1999-01-01 00:00:00