Higher aldosterone is associated with increased renal impairment risk in patients with hypertension and abnormal glucose metabolism: a longitudinal study

Lin, Mengyue; Heizhati, Mulalibieke; Gan, Lin; Yao, Xiaofeng; Luo, Qian; Zhang, Delian; Abulikemu, Suofeiya; Wang, Menghui; Wang, Guoliang; Jiang, Wen; Hu, Junli; Maimaiti, Nuerguli; Wang, Lei; Wu, Ting; Sun, Le; Yue, Na; Ren, Yingli; Li, Nanfang

doi:10.1097/hjh.0000000000003049

Cited by 9 publications

(11 citation statements)

References 34 publications

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“…Participants were inpatients from Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region in this retrospective study. The study design have been reported elsewhere ( 17 , 18 ). In brief, a total of 2,946 participants aged ≥ 18 years who diagnosed with hypertension and abnormal glucose metabolism between January 2012 and May 2019, were identified.…”

Section: Methodsmentioning

confidence: 99%

“…Diagnostic criteria for hypertension and abnormal glucose metabolism [including impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diagnosed DM] have been described in previous studies ( 17 , 18 ).…”

Section: Methodsmentioning

confidence: 99%

“…elsewhere (17,18). In brief, a total of 2,946 participants aged ≥ 18 years who diagnosed with hypertension and abnormal glucose metabolism between January 2012 and May 2019, were identified.…”

Section: Study Populationmentioning

confidence: 99%

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The non-linear relationship between triglyceride-glucose index and risk of chronic kidney disease in hypertensive patients with abnormal glucose metabolism: A cohort study

et al. 2022

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BackgroundTriglyceride–glucose (TyG) index has been reported to be associated with cardiovascular disease (CVD). However, few studies have focused on TyG index and the risk of chronic kidney disease (CKD). Thus, this study aims to explore the relationship between TyG index and CKD.MethodsA total of 2,033 participants with hypertension between January 2012 and May 2019 were included in the longitudinal observational study. All patients are grouped according to the TyG index quartile. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m2 and/or positive proteinuria. Multivariate Cox proportional hazards models were used to investigate the relationship between TyG index and CKD.ResultsDuring a median follow-up of 31 months, 302 participants developed CKD, with a mean age of 55.5 years and median TyG of 8.94. Compared with those in the lowest quartile of TyG index, participants in the highest quartile of TyG index exhibited 1.63-fold higher hazard ratio (95% CI: 1.14–2.33, P = 0.007) for presence of CKD. And restricted cubic spline analysis showed the relationship between TyG index and CKD is non-linear (P non-linearity = 0.021). The hazard ratio for CKD first fell and after rising until around 8.94 of TyG index and started to increase rapidly afterward (P for TyG < 0.001).ConclusionHigher TyG index is associated with the increased risk for CKD. Early intervention of metabolic factors may prevent the occurrence of CKD, thereby reducing the incidence of CVD and premature death.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The non-linear relationship between triglyceride-glucose index and risk of chronic kidney disease in hypertensive patients with abnormal glucose metabolism: A cohort study

et al. 2022

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“…Model 2 was adjusted for variables with significant differences among CVAI quartile groups, including age, sex, smoking status, drinking status, SBP, baseline eGFR, duration of hypertension, types of AGM, antidiabetic drugs, antihypertensive drugs, HbA1c, BUN, and hyperuricemia. Model 3 was adjusted for all included factors, including PAC, which has been recently shown to be independently associated with incident renal damage in hypertensives with AGM ( 20 ). Hazard ratios (HRs) for outcomes were calculated for quartiles CVAI (with the first quartile as reference), high CVAI (with the group below the median of CVAI as reference), and each SD increase of CVAI.…”

Section: Methodsmentioning

confidence: 99%

Chinese Visceral Adiposity Index Is Associated With Incident Renal Damage in Patients With Hypertension and Abnormal Glucose Metabolism: A Longitudinal Study

Lin

Heizhati

et al. 2022

Front. Endocrinol.

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ObjectiveTo evaluate the association between Chinese visceral adiposity index (CVAI) and incident renal damage and compared its predictive power with that of other visceral obesity indices in patients with hypertension and abnormal glucose metabolism (AGM).MethodsThis retrospective cohort consecutively included patients with hypertension and AGM who did not have renal damage at baseline. Renal damage was defined using the estimated glomerular filtration rate (eGFR) and urine protein. Multivariable Cox regression analysis was used to evaluate the association between CVAI and incident renal damage. Restricted cubic splines were used to determine the shape of the association. The predictive power of the CVAI was examined and directly compared with other indices, including the VAI, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), using the area under the receiver operating characteristic curve (AUC) and C-index.ResultsIn total, 2,033 patients with hypertension and AGM were included. During a median follow-up of 2.6 years, the incidence of renal damage was 31.5, 48.9, 56.8, and 67.5/1,000 person-years across the quartiles of CVAI. Compared with the first quartile, the risk of renal damage was higher in the second (hazard ratio (HR) = 1.36 [95% CI: 0.93−1.97]), third (HR = 1.57 [95% CI: 1.09−2.27]), and fourth (HR = 1.65 [95% CI: 1.11−2.44]) quartiles (p for trend = 0.011). A linear dose–response association was observed. Sensitivity and subgroup analyses confirmed the robustness and consistency of the results. In terms of predictive power, the CVAI had the highest AUC and C-index values.ConclusionsCVAI is positively associated with renal damage risk in a linear dose–response pattern and has the best performance in predicting incident renal damage in patients with hypertension and AGM. The CVAI may serve as a reliable indicator for identifying patients at a high risk of renal damage.

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“… 17 In addition, results may be biased by insufficient adjustment for confounding factors, such as aldosterone, which has recently been shown to be independently associated with incident CKD in hypertensive patients with GMD. 18 Therefore, the independently predictive value of PRA for kidney damage needs further validation.…”

Section: Introductionmentioning

confidence: 99%

Higher plasma renin activity is associated with increased kidney damage risk in patients with hypertension and glucose metabolic disorders

Lin

Heizhati

Gan

et al. 2022

J of Clinical Hypertension

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The impact of renin on kidney remain unclear among hypertensives with glucose metabolic disorders (GMD). We aimed to evaluate the association between plasma renin activity (PRA) and kidney damage in hypertensive patients with GMD. Overall, 2033 inpatients with hypertension and GMD free of chronic kidney disease (CKD) at baseline were included. CKD was defined using estimated glomerular filtration rate (eGFR) and urine protein. PRA was treated as continuous variable, and also dichotomized as high (≥0.65) or low (< 0.65) groups. The association of PRA with incident CKD was evaluated using multivariable Cox model controlling for antihypertensive medications and baseline aldosterone, and traditional parameters. Subgroup and interaction analyses were performed to evaluate heterogeneity. During a median follow‐up of 31 months, 291 participants developed CKD. The incidence was higher in high‐renin group than that in low‐renin group (54.6 vs 36.6/1000 person‐years). Significant association was observed between PRA and incident CKD, and the association was mainly driven by an increased risk for proteinuria. Each standard deviation increment in log‐transformed PRA was associated with 16.7% increased risk of proteinuria (hazard ratio = 1.167, P = .03); compared with low‐renin group, there was 78.4% increased risk for high‐renin group (hazard ratio = 1.784, P = .001). Nonlinear associations were observed between PRA and kidney damage. Higher PRA is associated with greater risk of incident kidney damage, especially for positive proteinuria, in patients with coexistence of hypertension and diabetes, independent of aldosterone. In this patient population with high risk for kidney damage, PRA may serve as an important predictor.

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Higher aldosterone is associated with increased renal impairment risk in patients with hypertension and abnormal glucose metabolism: a longitudinal study

Cited by 9 publications

References 34 publications

The non-linear relationship between triglyceride-glucose index and risk of chronic kidney disease in hypertensive patients with abnormal glucose metabolism: A cohort study

The non-linear relationship between triglyceride-glucose index and risk of chronic kidney disease in hypertensive patients with abnormal glucose metabolism: A cohort study

Chinese Visceral Adiposity Index Is Associated With Incident Renal Damage in Patients With Hypertension and Abnormal Glucose Metabolism: A Longitudinal Study

Higher plasma renin activity is associated with increased kidney damage risk in patients with hypertension and glucose metabolic disorders

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