Renal Hyperfiltration and Central Blood Pressures: A Populational Cohort Study
November 02, 2017 | 10:00 AM - 10:00 AM
Click an icon below to load this item into your calendar. Please note that times are exported as Coordinated Universal Time (UTC). Time zone help.
Abstract: TH-PO453
Renal Hyperfiltration and Central Blood Pressures: A Populational Cohort Study
Session Information
Category: Chronic Kidney Disease (Non-Dialysis)
- 303 CKD: Epidemiology, Outcomes - Cardiovascular
Authors
- Dupuis, Marie-Eve, Hopital du Sacre-Coeur, Montreal, Quebec, Canada
- Madore, Francois, Hopital du Sacre-Coeur, Montreal, Quebec, Canada
- Agharazii, Mohsen, CHUQ-HDQ, Quebec City, Alberta, Canada
- Goupil, Remi, Hopital du Sacre-Coeur, Montreal, Quebec, Canada
Background
Renal hyperfiltration (RHF) in non-diabetic individuals is linked to mortality and cardiovascular events. Whether increased central blood pressure (BP) plays a role in this association is unknown.
Methods
Of the 20,004 CARTaGENE participants, 14,580 non-diabetics with central BP were identified. From these, a group with RHF (eGFR >95th percentilestratified for sex and age) was compared to a control group (eGFR 25th to 75th percentile). Central BP parameters adjusted for known confounding factors were compared using multivariate regression and propensity score matching analyses.
Results
Baseline characteristics between RHF [eGFR 108.4 (IQR 105.3, 113.3) ml/min/1.73m2] and control [eGFR 89.9 (IQR 84.2, 95.9)] groups were similar apart from age, smoking status and BMI. All adjusted central BP parameters were higher with RHF on regression analyses. These results were replicated using propensity score matching (1:1 matching, n=721), apart from central systolic BP (113.2 ± 14.6 vs 112.3 ± 14.8, p=0.2).
Conclusion
In this populational cohort of non-diabetic individuals, RHF was associated with higher central BP parameters, independently of peripheral BP and other confounders. Whether this explain, at least in part, the increased cardiovascular morbidity and mortality associated with RHF remains to be determined.
| Demographic characteristics | RHF
(n=727) | Controls
(n=7,292) | p |
| Age | 52.1 ± 7.7 | 54.0 ± 7.7 | <0.001 |
| Sex | 48% | 48% | 1.0 |
| Cardiovascular disease | 3.6% | 3.2% | 0.6 |
| Hypertension | 18% | 18% | 1.0 |
| Smoking | 27% | 19% | <0.001 |
| BMI | 26.5 ± 5.4 | 27.1 ± 4.9 | 0.007 |
| Brachial systolic BP | 122.9 ± 15.3 | 123.5 ± 15.5 | 0.4 |
| Brachial pulse pressure | 49.7 ± 10.0 | 49.8 ± 10.6 | 0.8 |
| Adjusted central BP parameters* |
| Central systolic BP | 114.9 (114.5, 115.3) | 114.2 (113.9, 114.5) | <0.001 |
| Central pulse pressure | 40.7 (40.0, 41.4) | 39.6 (39.2, 40.1) | <0.001 |
| Augmentation index | 28.7 (27.9, 29.5) | 28.0 (27.4, 28.5) | 0.03 |
| Pulse pressure amplification | 1.277 (1.268, 1.286) | 1.287 (1.280, 1.293) | 0.01 |
| Augmented pressure | 12.1 (11.7, 12.5) | 11.6 (11.3, 11.9) | 0.001 |
*Adjusted for age, sex, smoking, cardiovascular disease, mean BP, heart rate, total cholesterol, HDL, glucose, weight, height, bio-impedance lean body mass, aspirin, statins, beta-blockers, renin-angiotensin blockers, calcium channel blockers and diuretics.