Relationship of arterial compliance and blood pressure with microalbuminuria and mildly decreased glomerular filtration rate: a Chinese community-based analysis.

Shihui Fu,Ping Ye,Leiming Luo,Yuqing Sun,Jeff M Sands

doi:10.1371/journal.pone.0101013

Shihui Fu, Ping Ye + Show 3 more

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https://doi.org/10.1371/journal.pone.0101013

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Abstract

ObjectiveThis analysis is designed to determine the prevalence of microalbuminuria (MAU) and mildly decreased glomerular filtration rate (GFR); to investigate the association of augmentation index (AIx), central blood pressure (cBP) and peripheral blood pressure (pBP) with MAU and mildly decreased GFR; and to compare the association strength of cBP and pBP with MAU and mildly decreased GFR.MethodsThis community-based analysis included 2071 Chinese residents. Urine albumin-to-creatinine ratio (UACR), GFR, and pulse wave measurements were performed. UACR of 30–299 mg/g and GFR of 60–89 ml/min/1.73 m2 were identified as MAU and mildly decreased GFR.ResultsThe prevalence of MAU and mildly decreased GFR was 21.3% and 33.2%. The AIx, cBP and pBP were significantly higher in participants with MAU compared with those without MAU, and in participants with mildly decreased GFR compared with those without mildly decreased GFR (all P<0.001). After participants were categorized into four subgroups based on the presence or absence of MAU and mildly decreased GFR, Aix, cBP and pBP progressively increased from the subgroup without both of MAU and mildly decreased GFR to the subgroups with either one of them, and arrived at top in the subgroup with both of them (all P<0.001). Compared with the reference category without MAU and mildly decreased GFR, the odd ratio values significantly increased from the category with either one of MAU and mildly decreased GFR to the category with both of them (all P<0.001). The AIx, cBP and pBP were all independently associated with MAU and mildly decreased GFR after full adjustment (all P<0.05), and the association strength of MAU and mildly decreased GFR with cBP was similar to those with pBP.ConclusionsIn Chinese community-dwelling population, there was a high prevalence of MAU and mildly decreased GFR. The AIx, cBP and pBP were all independently associated with MAU and mildly decreased GFR; meanwhile, cBP did not exhibit stronger association with MAU and mildly decreased GFR compared with pBP.

Highlights

Recent interest has been aroused in the relationship of renal demage with arterial compliance evaluated by augmentation index (AIx) and blood pressure including central blood pressure and peripheral blood pressure
The ethicty is an important factor that can affect the relationship of AIx, central blood pressure (cBP) and peripheral blood pressure (pBP) with MA and mildly decreased glomerular filtration rate (GFR), and most previous studies have focused on the westerners rather than Chinese community-dwelling residents
After participants were categorized into four subgroups based on the presence or absence of MAU and mildly decreased GFR, peripheral systolic blood pressure (pSBP), and AIx and central systolic blood pressure (cSBP), progressively increased from the subgroup without both of MAU and mildly decreased GFR to the subgroups with either one of them, and arrived at top in the subgroup with both of them (p, 0.001 for all, Figure 1)

Summary

Introduction

Recent interest has been aroused in the relationship of renal demage with arterial compliance evaluated by augmentation index (AIx) and blood pressure including central blood pressure (cBP) and peripheral blood pressure (pBP). Several studies have investigated the association of AIx, cBP and pBP with glomerular filtration rate (GFR) and urine albumin-to-creatinine ratio (UACR) as a continuous variable, but they obtained the inconsistent results [1,2,3,4,5,6,7,8,9,10]. Most studies have paid attention to the correlation of AIx, cBP and pBP with CKD and ESRD, but their relation to the early stage of renal function, i.e., mildly decreased GFR, is a relatively neglected topic [15]. The ethicty is an important factor that can affect the relationship of AIx, cBP and pBP with MA and mildly decreased GFR, and most previous studies have focused on the westerners rather than Chinese community-dwelling residents. There is almost no community-based study relating the AIx, cBP and pBP to MAU and mildly decreased GFR in

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