IgA nephropathy (IgAN) or Berger's disease is a slowly progressing disease that leads to end-stage renal disease in 50 % of the patients within 25 years of the disease. However, several factors are associated with the accelerated progression of this disease causing early development of end-stage disease. Persistent proteinuria or hematuria, poorly controlled hypertension, elevated serum creatinine and prevalent glomerulosclerosis are some of the risk factors that expedite the deteriorative effects of IgAN. Thus, the progression of the disease can be delayed if the associated risk factors are handled and addressed in the nick of time.
BackgroundThe aim of this study was to explore the relationship between age and acute mountain sickness (AMS) when subjects are exposed suddenly to high altitude.MethodsA total of 856 young adult men were recruited. Before and after acute altitude exposure, the Athens Insomnia Scale score (AISS) was used to evaluate the subjective sleep quality of subjects. AMS was assessed using the Lake Louise scoring system. Heart rate (HR) and arterial oxygen saturation (SaO2) were measured.ResultsResults showed that, at 500 m, AISS and insomnia prevalence were higher in older individuals. After acute exposure to altitude, the HR, AISS, and insomnia prevalence increased sharply, and the increase in older individuals was more marked. The opposite trend was observed for SaO2. At 3,700 m, the prevalence of AMS increased with age, as did severe AMS, and AMS symptoms (except gastrointestinal symptoms). Multivariate logistic regression analysis showed that age was a risk factor for AMS (adjusted odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01–1.13, P<0.05), as well as AISS (adjusted OR 1.39, 95% CI 1.28–1.51, P<0.001).ConclusionThe present study is the first to demonstrate that older age is an independent risk factor for AMS upon rapid ascent to high altitude among young adult Chinese men, and pre-existing poor subjective sleep quality may be a contributor to increased AMS prevalence in older subjects.
Background
It is unclear whether short‐term blood pressure variability is associated with renal outcomes in patients with chronic kidney disease.
Methods and Results
This study analyzed data from participants in the C‐
STRIDE
(Chinese Cohort Study of Chronic Kidney Disease) who had
chronic kidney disease
stages 1 to 4. Short‐term
blood pressure variability
was measured by calculating the weighted SD (w‐
SD
) of systolic blood pressure (
SBP
). Renal outcomes were defined as dialysis initiation and/or transplantation. Risk factors associated with w‐
SD
of
SBP
were evaluated by linear regression. Associations of short‐term SBP variability with renal outcomes were evaluated by Cox regression. In total, 1421 patients with
chronic kidney disease
were included in this study (mean age, 49.4±13.6 years; 56.2% men; estimated glomerular filtration rate, 50.5±29.3 mL/min per 1.73 m
2
; proteinuria, 0.9 [0.3–2.0] g/d). Mean w‐
SD
of
SBP
was 12.6±4.4 mm Hg. w‐
SD
of
SBP
was independently associated with older age, 24‐hour
SBP
, blood pressure circadian pattern, and angiotensin
II
receptor blocker treatment. During a median follow‐up of 4.9 years, 237 patients developed renal outcomes (37.01 per 1000 patient‐years). The incidence rate increased across the quartiles of w‐
SD
(log‐rank
P
=0.005). w‐
SD
of
SBP
was associated with an increased risk of renal outcomes, both as a continuous variable (hazard ratio [HR], 1.47; 95% CI, 1.09–1.99) and as a categorical variable (quartile 4 versus quartile 1: HR, 1.60; 95% CI, 1.08–2.36), independent of 24‐hour
SBP
, daytime
SBP
, and nighttime
SBP
.
Conclusions
Short‐term SBP was independently associated with the risk of dialysis initiation and/or transplantation in patients with
chronic kidney disease
.
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