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CVD risk in non-albuminuric chronic kidney disease in hypertensive, non-diabetic subjects: A post-hoc analysis from SPRINT
INTRODUCTION: The risks associated with non-albuminuric chronic kidney disease (CKD) have been investigated in diabetes mellitus but not in hypertensive patients. The objective of this study was to investigate the risks associated with non-albuminuric CKD in treated hypertensive patients in the Syst...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9768444/ https://www.ncbi.nlm.nih.gov/pubmed/36568559 http://dx.doi.org/10.3389/fcvm.2022.977938 |
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author | Sheng, Chang-Sheng Wang, Dan Yuan, Jiangzi Cheng, Yi Sun, Siming Yang, Yulin Miao, Ya Wang, Weiming Tian, Jingyan Bloomgarden, Zachary T. |
author_facet | Sheng, Chang-Sheng Wang, Dan Yuan, Jiangzi Cheng, Yi Sun, Siming Yang, Yulin Miao, Ya Wang, Weiming Tian, Jingyan Bloomgarden, Zachary T. |
author_sort | Sheng, Chang-Sheng |
collection | PubMed |
description | INTRODUCTION: The risks associated with non-albuminuric chronic kidney disease (CKD) have been investigated in diabetes mellitus but not in hypertensive patients. The objective of this study was to investigate the risks associated with non-albuminuric CKD in treated hypertensive patients in the Systolic Blood Pressure Intervention Trial (SPRINT) population. METHODS: Based on baseline albuminuria status (urine albumin/creatinine ratio [UACR], ≥30 or <30 mg/g) and the levels of estimated glomerular filtration rate ([eGFR], ≥60, 45–59, or <45 mL/min/1.73 m(2)), participants were classified into six subgroups to assess the risks associated with the primary outcome and mortality. The primary composite outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or mortality from cardiovascular causes. RESULTS: During a median follow-up of 3.26 years in 8,866 hypertensive patients, there were 352 deaths and 547 participants with the primary outcome. In adjusted Cox regression analysis using non-CKD and non-albuminuria (eGFR ≥60 mL/min/1.73 m(2) combined with UACR <30 mg/g) as reference, albuminuria whether combined with CKD or not, showed significantly higher risk of both primary outcome and all-cause mortality in the total population. Whereas, non-albuminuria only combined with eGFR <45 mL/min/1.73 m(2) showed significantly higher risk of both primary outcome and all-cause mortality in the intensive-therapy group. DISCUSSION: Non-albuminuric CKD did have higher risk of all-cause and CVD mortality only if the eGFR <45 mL/min/1.73 m(2). Increased albuminuria conferred higher risk of primary outcome and all-cause mortality irrespective the levels of eGFR. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, number: NCT01206062. |
format | Online Article Text |
id | pubmed-9768444 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97684442022-12-22 CVD risk in non-albuminuric chronic kidney disease in hypertensive, non-diabetic subjects: A post-hoc analysis from SPRINT Sheng, Chang-Sheng Wang, Dan Yuan, Jiangzi Cheng, Yi Sun, Siming Yang, Yulin Miao, Ya Wang, Weiming Tian, Jingyan Bloomgarden, Zachary T. Front Cardiovasc Med Cardiovascular Medicine INTRODUCTION: The risks associated with non-albuminuric chronic kidney disease (CKD) have been investigated in diabetes mellitus but not in hypertensive patients. The objective of this study was to investigate the risks associated with non-albuminuric CKD in treated hypertensive patients in the Systolic Blood Pressure Intervention Trial (SPRINT) population. METHODS: Based on baseline albuminuria status (urine albumin/creatinine ratio [UACR], ≥30 or <30 mg/g) and the levels of estimated glomerular filtration rate ([eGFR], ≥60, 45–59, or <45 mL/min/1.73 m(2)), participants were classified into six subgroups to assess the risks associated with the primary outcome and mortality. The primary composite outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or mortality from cardiovascular causes. RESULTS: During a median follow-up of 3.26 years in 8,866 hypertensive patients, there were 352 deaths and 547 participants with the primary outcome. In adjusted Cox regression analysis using non-CKD and non-albuminuria (eGFR ≥60 mL/min/1.73 m(2) combined with UACR <30 mg/g) as reference, albuminuria whether combined with CKD or not, showed significantly higher risk of both primary outcome and all-cause mortality in the total population. Whereas, non-albuminuria only combined with eGFR <45 mL/min/1.73 m(2) showed significantly higher risk of both primary outcome and all-cause mortality in the intensive-therapy group. DISCUSSION: Non-albuminuric CKD did have higher risk of all-cause and CVD mortality only if the eGFR <45 mL/min/1.73 m(2). Increased albuminuria conferred higher risk of primary outcome and all-cause mortality irrespective the levels of eGFR. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, number: NCT01206062. Frontiers Media S.A. 2022-12-07 /pmc/articles/PMC9768444/ /pubmed/36568559 http://dx.doi.org/10.3389/fcvm.2022.977938 Text en Copyright © 2022 Sheng, Wang, Yuan, Cheng, Sun, Yang, Miao, Wang, Tian and Bloomgarden. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Sheng, Chang-Sheng Wang, Dan Yuan, Jiangzi Cheng, Yi Sun, Siming Yang, Yulin Miao, Ya Wang, Weiming Tian, Jingyan Bloomgarden, Zachary T. CVD risk in non-albuminuric chronic kidney disease in hypertensive, non-diabetic subjects: A post-hoc analysis from SPRINT |
title | CVD risk in non-albuminuric chronic kidney disease in hypertensive, non-diabetic subjects: A post-hoc analysis from SPRINT |
title_full | CVD risk in non-albuminuric chronic kidney disease in hypertensive, non-diabetic subjects: A post-hoc analysis from SPRINT |
title_fullStr | CVD risk in non-albuminuric chronic kidney disease in hypertensive, non-diabetic subjects: A post-hoc analysis from SPRINT |
title_full_unstemmed | CVD risk in non-albuminuric chronic kidney disease in hypertensive, non-diabetic subjects: A post-hoc analysis from SPRINT |
title_short | CVD risk in non-albuminuric chronic kidney disease in hypertensive, non-diabetic subjects: A post-hoc analysis from SPRINT |
title_sort | cvd risk in non-albuminuric chronic kidney disease in hypertensive, non-diabetic subjects: a post-hoc analysis from sprint |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9768444/ https://www.ncbi.nlm.nih.gov/pubmed/36568559 http://dx.doi.org/10.3389/fcvm.2022.977938 |
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