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January 1, 2019Journal of MedicineOpen Access

High systolic blood pressure in patients with chronic kidney disease was significantly associated with higher urine albumin-to-creatinine ratio (median 1789 vs 164, p<0.001) and increased inflammation.

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Why the study?

Activation of the renin-angiotensin system in hypertension was believed to drive endothelial dysfunction, micro-inflammation, and reactive oxygen species generation, motivating an evaluation of blood pressure interactions with cardiovascular risk factors in CKD.

Is high blood pressure associated with elevated oxidative stress, inflammatory markers, and albuminuria in patients with chronic kidney disease?

Population

71 patients with CKD across three hospitals in Surabaya, Indonesia

Comparison

Participants grouped by systolic and diastolic blood pressure levels

Design

Observational cross-sectional study

Key result

High systolic blood pressure in patients with chronic kidney disease was significantly associated with higher urine albumin-to-creatinine ratio (median 1789 vs 164, p<0.001) and increased inflammation.

Authors

MTMochammad ThahaIKIka N. KadariswantiningsihMEMaulana A. Empitu

Discussion

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Member takes

Overview

High BP associated with oxidative stress, inflammation, and albuminuria in CKD; leaves open whether tighter control mitigates these markers in prospective studies.

Study Design

Type

Cross-Sectional (n=71)

Multicenter

Yes

Structured PICO

Is high blood pressure associated with elevated oxidative stress, inflammatory markers, and albuminuria in patients with chronic kidney disease?

P
Population
71 patients with chronic kidney disease (median age 59, 37% on hemodialysis) evaluated in a cross-sectional study to assess the association of blood pressure with oxidative stress and inflammation.
E
Exposure
High systolic and diastolic blood pressure
C
Comparator
Lower/normal systolic and diastolic blood pressure
O
Outcome
Levels of oxidative stress markers (MDA, TAC), inflammatory markers (hs-CRP, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio), and urine albumin-to-creatinine ratio (ACR)surrogate

Main Result

Absolute Event Rate: 1789% vs 164%

p-value: p=<0.001

In patients with CKD, high blood pressure is significantly associated with increased markers of inflammation, oxidative stress, and albuminuria.

Limitations

  • Cross-sectional design cannot infer causality relationship
  • Small sample size may have resulted in weak to moderate associations

Cite This Study

Thaha et al. (2019) conducted a cross-sectional in Chronic Kidney Disease (n=71). High systolic blood pressure (>139 mmHg) vs. Normal systolic blood pressure was evaluated on Urine Albumin-to-Creatinine Ratio (ACR) (p=<0.001). High systolic blood pressure in patients with chronic kidney disease was significantly associated with higher urine albumin-to-creatinine ratio (median 1789 vs 164, p<0.001) and increased inflammation.

synapsesocial.com/papers/6a97df989f0d7a8a1afac984https://doi.org/10.3329/jom.v20i1.38815
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Endothelial function, CRP and oxidative stress in chronic kidney disease2005 · 98 citations
  2. 2Oxidative stress and Antioxidant Enzyme levels In Hypertensive Chronic Kidney Disease patients2014 · 5 citations
  3. 3The role of oxidative stress markers in Indonesian chronic kidney disease patients: a cross sectional study2022 · 1 citations
  4. 4Evaluation and Correlation of Urinary Micro Albumin in Early Diagnosis of Patients with Hypertension Related Chronic Kidney Disease2024
  5. 5Phenotyping Kidney Function in Young Adults With High Blood Pressure: The African‐PREDICT Study2024