Shape of the Relationship between Hypertension and the Rate of Progression of Renal Failure in Autosomal Dominant Polycystic Kidney Disease

Abstract

The effect of hypertension on the rate of progression of renal failure was analyzed in 26 patients with autosomal dominant polycystic kidney disease relating the slopes of progression (linear regression of the reciprocal serum creatinine on time) with the average mean arterial pressure, systolic and diastolic pressure, derived over the entire follow-up period for each patient. Hypertension was found in 19 of the 26 patients. Using simple linear regression, there was no significant correlation between the two variables in any case. Using polynomial regression (quadratic and cubic), this relationship fits a sigmoid (for diastolic pressure) or a negative parabolic curve (for mean arterial pressure and systolic pressure); i.e. the lowest and the highest values of mean arterial pressure and systolic pressure were associated with faster rates of progression. Thus, an appropriate model to study this relationship is not the linear but the polynomial regression.

Predictive factors of progression of chronic renal insufficiency: a multivariate analysis

“…The predialysis period would be the ideal time for appropriate intervention and correction of many factors associated with progressive renal disease, such as hypertension, acidosis, renal osteodystrophy, and malnutrition. Most studies on adult populations have demonstrated that some factors are consistently associated with progression to ESRF, such as hypertension, proteinuria, renal function at baseline, primary renal disease, and male gender [24,25,26,27,28,29,30,31,32,33]. Several studies have demonstrated that delayed referral of patients with CRI to the nephrologist adversely affects outcome [14,15,16].…”

Clearance and Safety of the Radiocontrast Medium Iopamidol in Peritoneal Dialysis Patients

“…The accumulation or delayed elimination of iodinated radiocontrast media may cause adverse events in chronic dialysis patients with anuria or cardiovascular dysfunction. Several reports have demonstrated acute adverse events such as heat sensations, acute urticaria, and iododerma, and delayed reactions such as vasculitis, skin disorders, submandibular swelling, and sialoadenitis even with the use of low osmolar nonionic contrast media [2, 7, 10–13]. However, not much is known about the adverse events caused by delayed elimination.…”