Circadian variation of urinary microalbumin excretion and ambulatory blood pressure in patients with essential hypertension

Hishiki, Satoshi; Tochikubo, Osamu; Miyajima, Eiji; Ishii, Masao

doi:10.1097/00004872-199816121-00036

Cited by 16 publications

(8 citation statements)

References 32 publications

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“…Whether a urine sample is centrifuged, filtered, or not treated, the albumin concentration decreases by 0.27%/day at Ϫ20°C but shows no decreases over 160 days at Ϫ80°C (359 ). The urinary albumin excretion rate does not show marked diurnal variation in diabetes but does so in essential hypertension (360 ). A (moderate).…”

Section: Gppmentioning

confidence: 94%

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

et al. 2011

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BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence Based Laboratory Medicine Committee of the AACC jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (Hb A1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

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Section: Gppmentioning

confidence: 94%

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

et al. 2011

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“…Whether a urine sample is centrifuged, filtered, or not treated, the albumin concentration decreases by 0.27%/day at −20°C but shows no decreases over 160 days at −80°C (359). The urinary albumin excretion rate does not show marked diurnal variation in diabetes but does so in essential hypertension (360). …”

Section: Glucosementioning

confidence: 99%

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

et al. 2011

View full text Add to dashboard Cite

BACKGROUNDMultiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially.APPROACHAn expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association.CONTENTIn addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (HbA1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of HbA1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed.SUMMARYThe guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

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“…In patients with essential hypertension, in fact, it was reported that the AER has a significant correlation with the mean values of the 24-hour BP [24,25]. When the BP and urine data were divided into five time periods of the day, a significant positive correlation between BP and AER was found in 78% of the patients with essential hypertension [26]. However, these studies did not examine a relationship between day-night rhythms of BP and AER.…”

Section: Discussionmentioning

confidence: 98%

Disturbed Circadian Rhythm of Urinary Albumin Excretion in Non-Dipper Type of Essential Hypertension

Nishimura

Uzu²,

Fujii³

et al. 2002

Am J Nephrol

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Recently, we found that the circadian rhythms of natriuresis as well as of glomerular filtration rate were disturbed similar to the blood pressure in non-dipper type of essential hypertension during intake of a high-sodium diet. In this study, we examined circadian rhythms of the urinary albumin excretion rate (AER), which is recognized as a marker of glomerular capillary hydraulic pressure, in addition to those of urinary sodium excretion and blood pressure in 27 patients with essential hypertension. The patients were maintained on relatively high (10–12 g) on low (1–3 g) sodium (NaCl) diets for 1 week. On the last day of each diet, the 24-hour blood pressure was measured every 30 min noninvasively, and during the last 3 days, urine samples were collected for determination of both daytime (07:00–21.30 h) and nighttime (21.30–07.00 h) sodium and AER variations. During the high-sodium diet, nocturnal falls in urinary sodium excretion and blood pressure were observed in dippers (n = 7), while they were not observed in non-dipper (n = 20). The nocturnal decline in AER was also observed in dippers (day: 37 ×/÷ 6 µg/min vs. night: 22 ×/÷ 5 µg/min; p < 0.02), while it was not observed in non-dippers (day: 49 ×/÷ 6 µg/min vs. night: 40 ×/÷ 8 µg/min; NS). During intake of the low-sodium diet, on the other hand, a nocturnal decline in AER was observed in both types of hypertension. Sodium restriction significantly reduced only the nighttime AER in non-dippers (p < 0.01). These findings indicate that changes in dietary sodium intake modified the circadian rhythms of both blood pressure and AER in non-dippers. Renal sodium handling may contribute to determining the circadian rhythm of blood pressure, and furthermore an elevated glomerular capillary hydraulic pressure during the night may enhance the nocturnal albumin excretion in non-dippers.

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Circadian variation of urinary microalbumin excretion and ambulatory blood pressure in patients with essential hypertension

Cited by 16 publications

References 32 publications

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Disturbed Circadian Rhythm of Urinary Albumin Excretion in Non-Dipper Type of Essential Hypertension

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