Office and Ambulatory Heart Rate as Predictors of Age-Related Kidney Function Decline

Eriksen, Bjørn Odvar; Småbrekke, Silje; Jenssen, Trond; Mathisen, Ulla Dorte; Norvik, Jon Viljar; Schei, Jørgen; Schirmer, Henrik; Solbu, Marit Dahl; Stefansson, Vidar Tor Nyborg; Melsom, Toralf

doi:10.1161/hypertensionaha.118.11594

Cited by 8 publications

(6 citation statements)

References 29 publications

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“…There is no consensus on the definition of accelerated GFR decline in population-based studies, and some have used an absolute or percentage change in GFR based on the baseline to FU assessment [ 8 , 9 , 26 ]. This method provides an imprecise estimate of GFR change that is more prone to misclassification compared with using the rate of GFR change.…”

Section: Discussionmentioning

confidence: 99%

“…In sensitivity analyses, we defined accelerated GFR decline as the 25% fastest decliners based on the GFR slope calculated as described above, and as an annual GFR loss of >3 mL/min/1.73 m 2 or as twice the unadjusted cohort mean (calculated by the difference in GFR from baseline to FU divided by the observation time), methods that have been used in previous studies [ 8 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

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Serum matrix metalloproteinase 7 and accelerated glomerular filtration rate decline in a general non-diabetic population

Enoksen

Svistounov

Norvik

et al. 2021

Nephrology Dialysis Transplantation

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Background Age-related reduction of glomerular filtration rate (GFR) is a major contributor to the global chronic kidney disease (CKD) epidemic. We investigated whether baseline serum levels of the pro-fibrotic matrix metalloproteinase 2 (MMP2), MMP7 and their inhibitor, tissue inhibitor of metalloproteinase 1 (TIMP1), which mediates fibrosis development in aging animals, were associated with GFR decline in a general non-diabetic population. Methods In the Renal Iohexol Clearance Survey, we measured GFR using iohexol clearance in 1627 subjects aged 50–64 years without self-reported diabetes, kidney or cardiovascular disease. After a median of 5.6 years, 1324 had follow-up GFR measurements. Using linear mixed models and logistic regression analyses, we evaluated the association of MMP7, MMP2 and TIMP1 with the mean GFR decline rate, risk of accelerated GFR decline (defined as subjects with the 10% steepest GFR slopes: ≥1.8 mL/min/1.73 m2/year) and incident CKD [GFR <60 mL/min/1.73 m2 and/or urinary albumin to creatinine ratio (ACR) ≥3.0 mg/mmol]. Results Higher MMP7 levels (per standard deviation increase of MMP7) were associated with steeper GFR decline rates [−0.23 mL/min/1.73 m2/year (95% confidence interval −0.34 to −0.12)] and increased risk of accelerated GFR decline and incident CKD [odds ratios 1.58 (1.30–1.93) and 1.45 (1.05–2.01), respectively, in a model adjusted for age, sex, baseline GFR, ACR and cardiovascular risk factors]. MMP2 and TIMP1 showed no association with GFR decline or incident CKD. Conclusions The pro-fibrotic biomarker MMP7, but not MMP2 or TIMP1, is associated with increased risk of accelerated GFR decline and incident CKD in middle-aged persons from the general population.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Serum matrix metalloproteinase 7 and accelerated glomerular filtration rate decline in a general non-diabetic population

Enoksen

Svistounov

Norvik

et al. 2021

Nephrology Dialysis Transplantation

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“…There are data showing an association between baseline blood pressure (BP) and subsequent GFR decline and/or development of CKD. However, some authors shown no relationship between these factors [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Early functional and metabolic disorders in children with type I diabetes mellitus and diabetic nephropathy

Burlaka¹,

Maidannyk²

2021

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Type 1 diabetes (T1D) is mainly a disease of children and young adults. The onset of disease is associated with 3 classical symptoms: polydipsia, polyphagia, and polyuria. Hyperglycaemia is the main and primary metabolic disorder in T1D. One of the complications developing as a result of microangiopathy is diabetic nephropathy (DN). Additionally, diabetes remains the most common reason for progressing to end-stage renal disease (ESRD). The aim of the study was to evaluate the most initial metabolic and functional disorders in diabetic children and children with DN.The study involved 76 children with T1D and diabetic nephropathy (aged 3 to 17 years). The levels of ET-1 measured using ELISA assay and ratio of lipid oxidation measured spectrophotometrically. Main clinical parameters (blood pressure, glycaemia, albuminuria, creatininaemia, HbA 1C , cholesterol levels) were measured using conventional methods available in Clinical Paediatric Hospital No. 6 (Kyiv, Ukraine). The glomerular filtration rate (GFR) was calculated using the Schwartz formula. Patterns of the BP changes, kidney function impairment, ET-level, and metabolic and functional disorders in children with T1D and DN were found.

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“…Heart rate (HR) is a clinically accessible indicator of vital signs and sympathetic activity, 4 which has been reported to be predictive of all‐cause mortality, cardiovascular disease, and renal outcome. 5 , 6 , 7 Similar to blood pressure, HR follows circadian rhythms; that is, it normally decreases by 10–20% at night due to the effect of the parasympathetic system, 8 , 9 a night HR decline less than 10% from day is defined as the HR non‐dippers.…”

Section: Introductionmentioning

confidence: 99%

Nocturnal heart rate rising is a risk factor for poor renal outcomes in patients with chronic kidney disease and hypertension

Liu

Zhou

et al. 2022

J of Clinical Hypertension

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The association of heart rate (HR) dipping pattern with renal outcomes in chronic kidney disease (CKD) patients with hypertension has never been investigated. In order to demonstrate if HR dipping pattern is a risk factor for renal outcomes, cardiovascular (CV) diseases, and mortality in hypertensive patients with CKD, we conducted the prospective longitudinal observational study. Patients were divided into three groups according to their nocturnal HR: HR dippers (night-day HR ratio ≤ 0.9), HR non-dippers (0.9 < night-day HR ratio ≤ 1.0), and HR risers (night-day HR ratio > 1.0). The primary outcome was renal endpoint, a composite outcome of progression to end-stage renal disease (ESRD) or estimated glomerular filtration rate (eGFR) decline ≥ 50%; the secondary outcomes included poor renal outcomes, CV events, and death. A total of 34 (11.3%) patients reached renal endpoint after a follow-up of 34 ± 17 months. Both HR non-dippers and HR risers were predictive to renal endpoint (hazard ratio 2.58, 95% confidence interval (CI) 1.04-6.4, P = .04; hazard ratio 3.95, 95% CI 1.33-11.79, P = .01, respectively), while only HR risers was shown to be correlated with a decline in eGFR≥ 50% (hazard ratio 5.28, 95% CI 1.45-19.16, P < .05), and decline in eGFR (β -0.17, 95% CI -0.33--0.01, P = .04). No predictive value was found for HR dipping pattern to mortality and CV events. In conclusion, our study provided the first evidence that HR nondippers, especially risers were a risk factor for poor renal outcomes in hypertensive patients with CKD.

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Office and Ambulatory Heart Rate as Predictors of Age-Related Kidney Function Decline

Cited by 8 publications

References 29 publications

Serum matrix metalloproteinase 7 and accelerated glomerular filtration rate decline in a general non-diabetic population

Serum matrix metalloproteinase 7 and accelerated glomerular filtration rate decline in a general non-diabetic population

Early functional and metabolic disorders in children with type I diabetes mellitus and diabetic nephropathy

Nocturnal heart rate rising is a risk factor for poor renal outcomes in patients with chronic kidney disease and hypertension

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