title: Time for reflection predicts the progression of renal dysfunction in patients with nondiabetic chronic kidney disease.
abstract: Our previous data indicated that both home blood pressure and arterial stiffness predicted the progression of renal dysfunction in the patients with chronic kidney diseases. In the present study, we examined both home blood pressure and the parameters of arterial stiffness as the indicator to the progression of chronic kidney diseases. Forty-two nondiabetic chronic kidney disease patients were enrolled and followed for 1 year. Anti-hypertensive therapy was adjusted to achieve office blood pressure below 130/80 mmHg. Home blood pressure was examined twice a day in the morning and evening. Pulse wave velocity (PWV) and augmentation index (AI) were measured as the index of arterial stiffness. The time for reflection (TR) was also determined. The relationship of annual changes in serum creatinine (Scr) with the above parameters was assessed. Multivariate regression analysis revealed that TR inversely correlated to annual increase in Scr (beta = -0.03, p < 0.05). Home blood pressure did not correlate to annual changes in Scr in the present study. The present data indicated that arterial stiffness is elevated despite good blood pressure control in chronic kidney disease, especially among the dippings. In addition, our data suggest that PWV and AI correlated to each other, while they were influenced differently by hemodynamic factors. Finally, the present findings provide the evidence that the arterial stiffness parameter is more sensitive than home blood pressure as an indicator to the progression of chronic kidney disease.
authors.affiliation: Department of Nephrology, Saitama Medical University, School of Medicine, 38 Moro-Hongo Moroyama, Iruma, Saitama, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takenaka
authors.forename: Taku
authors.initials: T
authors.lastname: Mimura
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kikuta
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Kato
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Inoue
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kanno
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ohno
authors.forename: Tasuya
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Miyawaki
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D004548:Elasticity / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000503:physiopathology*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011237:Predictive Value of Tests; D011673:Pulsatile Flow / Q000502:physiology*; D017534:Radial Artery / Q000503:physiopathology*; D012189:Retrospective Studies
chemical_list: D003404:Creatinine