Why the study?
Are morning proteinuria and systolic blood pressure associated with the decline of renal function in type 2 diabetic patients with hypertension and nephropathy?
Are morning proteinuria and systolic blood pressure associated with the decline of renal function in type 2 diabetic patients with hypertension and nephropathy?
In diabetic patients with hypertension and nephropathy, morning levels of systolic blood pressure and proteinuria are significantly associated with the progression of renal dysfunction.
Supports monitoring proteinuria and SBP to track renal risk in diabetic nephropathy; leaves open whether targeting them slows progression.
The aim of this study was to investigate a significance of increased proteinuria in the morning and the effects of antihypertensive treatment on proteinuria and arterial blood pressure in the progression of chronic renal insufficiency in type 2 diabetic patients with hypertension and nephropathy. In three 24-hr urine samples and blood pressure monitoring, separated into a night-and daytime and spot urine in the morning, variation in protein-creatinine ratio (g/g) and blood pressure were assessed in 24 (58 +/- 3 years old; M/F: 17/7) diabetic patients with hypertension and nephropathy. Furthermore, the effects of antihypertensive therapy of combinations of angiotensin converting enzyme (ACE) inhibitor, calcium antagonists, diuretics, and alpha1 blocker were evaluated in 3 years. Home blood pressure measurement was carried out every month and 24-hr urine was collected every 2 months. The baseline urine excretion of protein-creatinine ratio and blood pressure were (1.22 +/- 0.13 g/g creatinine: 154/96 +/- 6/5 mmHg) in daytime and (1.39 +/- 0.13: 168/88 +/- 15/7) in the morning. At the end of the study, significant associations among a decline of 24-hr creatinine clearance and both of the urine excretion of protein-creatinine ratio (r = 0.47, p < .01) and the levels of systolic blood pressure (r = 0.46, p < .01) and between the levels of systolic blood pressure and the urine excretion of protein-creatinine ratio in the morning (r = 0.57, p < .001) were demonstrated. However, there were no significant associations among other variables. Analysis of patients who had systolic blood pressure in the morning less than 140 mmHg revealed that 65% of these patients received doxazosin-averaged doses of 4.8 +/- 1.5 mg daily. The levels of both blood pressure and proteinuria-creatinine ratio in the morning mainly associate with progression of renal function in diabetic patients with hypertension and nephropathy.
No takes yet. Share an insight, caveat, or question.
Suzuki et al. (2005) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: