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Decline of renal function is associated with proteinuria and systolic blood pressure in the morning in diabetic nephropathy.
Clin Exp Hypertens. 2005 Feb-Apr; 27(2-3):129-38.CE

Abstract

The aim of this study was to investigate a significance of increased proteinuria in the morning and the effects of antihypertensive treatment on proteinuria and arterial blood pressure in the progression of chronic renal insufficiency in type 2 diabetic patients with hypertension and nephropathy. In three 24-hr urine samples and blood pressure monitoring, separated into a night-and daytime and spot urine in the morning, variation in protein-creatinine ratio (g/g) and blood pressure were assessed in 24 (58 +/- 3 years old; M/F: 17/7) diabetic patients with hypertension and nephropathy. Furthermore, the effects of antihypertensive therapy of combinations of angiotensin converting enzyme (ACE) inhibitor, calcium antagonists, diuretics, and alpha1 blocker were evaluated in 3 years. Home blood pressure measurement was carried out every month and 24-hr urine was collected every 2 months. The baseline urine excretion of protein-creatinine ratio and blood pressure were (1.22 +/- 0.13 g/g creatinine: 154/96 +/- 6/5 mmHg) in daytime and (1.39 +/- 0.13: 168/88 +/- 15/7) in the morning. At the end of the study, significant associations among a decline of 24-hr creatinine clearance and both of the urine excretion of protein-creatinine ratio (r = 0.47, p < .01) and the levels of systolic blood pressure (r = 0.46, p < .01) and between the levels of systolic blood pressure and the urine excretion of protein-creatinine ratio in the morning (r = 0.57, p < .001) were demonstrated. However, there were no significant associations among other variables. Analysis of patients who had systolic blood pressure in the morning less than 140 mmHg revealed that 65% of these patients received doxazosin-averaged doses of 4.8 +/- 1.5 mg daily. The levels of both blood pressure and proteinuria-creatinine ratio in the morning mainly associate with progression of renal function in diabetic patients with hypertension and nephropathy.

Authors+Show Affiliations

Suzuki H
Department of Nephrology, Saitama Medical School, Saitama, Japan. iromichi@saitama-med.ac.jp
Kanno Y
No affiliation info available
Nakamoto H
No affiliation info available
Okada H
No affiliation info available
Sugahara S
No affiliation info available

MeSH

Angiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsBlood GlucoseBlood PressureBlood Pressure Monitoring, AmbulatoryCircadian RhythmCreatinineDiabetes Mellitus, Type 2Diabetic NephropathiesDisease ProgressionDrug Therapy, CombinationFemaleFollow-Up StudiesGlomerular Filtration RateHumansHypertensionKidney Failure, ChronicMaleMiddle AgedProteinuriaRetrospective Studies

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15835375

Citation

Suzuki, Hiromichi, et al. "Decline of Renal Function Is Associated With Proteinuria and Systolic Blood Pressure in the Morning in Diabetic Nephropathy." Clinical and Experimental Hypertension (New York, N.Y. : 1993), vol. 27, no. 2-3, 2005, pp. 129-38.
Suzuki H, Kanno Y, Nakamoto H, et al. Decline of renal function is associated with proteinuria and systolic blood pressure in the morning in diabetic nephropathy. Clin Exp Hypertens. 2005;27(2-3):129-38.
Suzuki, H., Kanno, Y., Nakamoto, H., Okada, H., & Sugahara, S. (2005). Decline of renal function is associated with proteinuria and systolic blood pressure in the morning in diabetic nephropathy. Clinical and Experimental Hypertension (New York, N.Y. : 1993), 27(2-3), 129-38.
Suzuki H, et al. Decline of Renal Function Is Associated With Proteinuria and Systolic Blood Pressure in the Morning in Diabetic Nephropathy. Clin Exp Hypertens. 2005 Feb-Apr;27(2-3):129-38. PubMed PMID: 15835375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decline of renal function is associated with proteinuria and systolic blood pressure in the morning in diabetic nephropathy. AU - Suzuki,Hiromichi, AU - Kanno,Yoshihiko, AU - Nakamoto,Hidetomo, AU - Okada,Hirokazu, AU - Sugahara,Souichi, PY - 2005/4/20/pubmed PY - 2005/7/8/medline PY - 2005/4/20/entrez SP - 129 EP - 38 JF - Clinical and experimental hypertension (New York, N.Y. : 1993) JO - Clin Exp Hypertens VL - 27 IS - 2-3 N2 - The aim of this study was to investigate a significance of increased proteinuria in the morning and the effects of antihypertensive treatment on proteinuria and arterial blood pressure in the progression of chronic renal insufficiency in type 2 diabetic patients with hypertension and nephropathy. In three 24-hr urine samples and blood pressure monitoring, separated into a night-and daytime and spot urine in the morning, variation in protein-creatinine ratio (g/g) and blood pressure were assessed in 24 (58 +/- 3 years old; M/F: 17/7) diabetic patients with hypertension and nephropathy. Furthermore, the effects of antihypertensive therapy of combinations of angiotensin converting enzyme (ACE) inhibitor, calcium antagonists, diuretics, and alpha1 blocker were evaluated in 3 years. Home blood pressure measurement was carried out every month and 24-hr urine was collected every 2 months. The baseline urine excretion of protein-creatinine ratio and blood pressure were (1.22 +/- 0.13 g/g creatinine: 154/96 +/- 6/5 mmHg) in daytime and (1.39 +/- 0.13: 168/88 +/- 15/7) in the morning. At the end of the study, significant associations among a decline of 24-hr creatinine clearance and both of the urine excretion of protein-creatinine ratio (r = 0.47, p < .01) and the levels of systolic blood pressure (r = 0.46, p < .01) and between the levels of systolic blood pressure and the urine excretion of protein-creatinine ratio in the morning (r = 0.57, p < .001) were demonstrated. However, there were no significant associations among other variables. Analysis of patients who had systolic blood pressure in the morning less than 140 mmHg revealed that 65% of these patients received doxazosin-averaged doses of 4.8 +/- 1.5 mg daily. The levels of both blood pressure and proteinuria-creatinine ratio in the morning mainly associate with progression of renal function in diabetic patients with hypertension and nephropathy. SN - 1064-1963 UR - https://www.unboundmedicine.com/medline/citation/15835375/Decline_of_renal_function_is_associated_with_proteinuria_and_systolic_blood_pressure_in_the_morning_in_diabetic_nephropathy_ DB - PRIME DP - Unbound Medicine ER -