4.5 Article

Effect of blood pressure trajectory and variability on new-onset chronic kidney disease in patients with type 2 diabetes

期刊

HYPERTENSION RESEARCH
卷 45, 期 5, 页码 876-886

出版社

SPRINGERNATURE
DOI: 10.1038/s41440-022-00882-8

关键词

Type 2 diabetes; Chronic kidney disease; Blood pressure trajectory; Blood pressure variability

资金

  1. Ministry of Science and Technology of Taiwan [MOST 104-2314-B-039-016, MOST 105-2314-B-039-021-MY3, MOST 105-2314-B-039-025-MY3, MOST 107-2314-B-039-049, MOST 108-2314-B-039-039, MOST 108-2314-B-039-035-MY3, MOST 108-2314-B-039-031-MY2, MOST 109-2314-B-039-031-MY2, MOST 110-2314-B-039-021-]
  2. China Medical University Hospital [DMR-110-076]

向作者/读者索取更多资源

This study aimed to evaluate the effects of BP trajectory and variability on chronic kidney disease (CKD) incidence in patients with type 2 diabetes. The study found that there is an association between BP trajectory and variability and CKD risk, with patients in the high-downward-upward DBP trajectory and high variability group facing a higher risk of CKD.
This study aimed to evaluate the effects of BP trajectory and variability on chronic kidney disease (CKD) incidence in patients with type 2 diabetes. This retrospective longitudinal study included 4,560 participants with type 2 diabetes, aged >= 30 years, free of CKD, with >= 3 years of follow-up, and who attended the Diabetes Care Management Program in 2001-2013. The follow-up period ended in 2016. The adverse outcome was a new-onset CKD event, which was determined using eGFR and albuminuria. Cox proportional hazards models were used to assess the associations. At the end of the follow-up, 1255 participants had developed CKD, with a mean follow-up of 4.3 +/- 3.2 years. Three trajectory subgroups of BP, i.e., Cluster 1: moderate-stable for SBP and moderate-downward for DBP, Cluster 2: low-upward-downward for both SBP and DBP, and Cluster 3: high-downward-upward for both SBP and DBP, were generated. The BP variability was grouped into three classes on the basis of tertiles. For the BP trajectory, patients in Cluster 3 of DBP had a higher CKD risk than those in Cluster 1 (HR = 1.24, 95% CI = 1.03-1.50). For the BP variability, patients in Tertile 3 had a significantly higher CKD risk than those in Tertile 1 (SBP: 1.28, 1.11-1.47; DBP: 1.17, 1.02-1.34). Persons with type 2 diabetes who achieved a small reduction in DBP after participating in the education program but rebounded and those who had the highest variation in both SBP and DBP faced the highest increase in CKD risk.

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