title: Renal histopathological findings in relation to ambulatory blood pressure in chronic kidney disease patients.
abstract: Recent studies have demonstrated that ambulatory blood pressure monitoring is useful for predicting the long-term renal prognosis and future cardiovascular events in chronic kidney disease patients. Currently, however, information is limited regarding the relationships between individual renal histopathological findings and abnormalities in ambulatory blood pressure. This retrospective cross-sectional study included a total of 138 patients, in whom both renal biopsies and ambulatory blood pressure monitoring were performed during the same admission period. Renal histopathological findings, including global glomerulosclerosis, interstitial fibrosis/tubular atrophy and the presence of arterial lesions and arteriole lesions, were scored and analyzed in relation to the ambulatory blood pressure values. Among these histopathological characteristics, only the severity of interstitial fibrosis/tubular atrophy exhibited a significant association with an increased mean value of daytime and nighttime blood pressure. However, the remaining histopathological features showed only trends or weak relationships with these values. In addition, a moderately advanced grade of interstitial fibrosis/tubular atrophy was found to be significantly associated with both daytime and nighttime hypertension, independent of the kidney function, overt proteinuria and the use of antihypertensive medications, according to multivariate analyses. Furthermore, the night-to-day ratio of the mean blood pressure displayed a significant increasing trend according to the grade of interstitial fibrosis/tubular atrophy. These results suggest that interstitial fibrosis/tubular atrophy is the most relevant renal histopathological parameter associated with abnormalities in ambulatory blood pressure, including nocturnal hypertension, in this population.
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Haruhara
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Tsuboi
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Koike
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fukui
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ogura
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokoo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000473:pathology* / Q000503:physiopathology; D012189:Retrospective Studies; D055815:Young Adult