Relationship between Hypertension and the Declining Renal Function in Korean Adults
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This study examined the association between hypertension (HTN), estimated glomerular filtration rate (eGFR), and urine microalbumin/creatinine ratio (ACR) in Korean adults. Data for 8,922 adults (3,941 men and 4,981 women) aged ≥20 years from the Sixth Korean National Health and Nutrition Examination Survey VI (2013∼2014) were analyzed. In men, after adjusting for the related variables, the odds ratios (ORs) of HTN [systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or use of HTN medications] were significantly higher in the decreased eGFR group [eGFR ＜60 mL/min/1.73 m2, 1.98 (95% CI, 1.21∼3.24)], elevated ACR group [ACR ≥30 mg/g, 2.03 (95% CI, 1.54∼2.69)], and decreased eGFR plus elevated ACR group [eGFR ＜60 mL/min/1.73 m2 and ACR ≥30 mg/g, 6.03 (95% CI, 2.82∼12.92)] than in the normal group (eGFR ≥60 mL/min/1.73 m2 and ACR ＜30 mg/g). In women, after adjusting for the related variables, the ORs of HTN were significantly higher in the decreased eGFR group (2.29, 95% CI, 1.27∼4.13), elevated ACR group (2.22, 95% CI, 1.68∼2.94), and decreased eGFR plus elevated ACR group (10.77, 95% CI, 3.89∼29.82) than the normal group. In conclusion, HTN was associated with a decreased eGFR and elevated ACR in Korean men and women. In addition, the prevalence of HTN increased greatly when a decreased eGFR and elevated ACR occurred simultaneously.
Abstract
This study examined the association between hypertension (HTN), estimated glomerular filtration rate (eGFR), and urine microalbumin/creatinine ratio (ACR) in Korean adults. Data for 8,922 adults (3,941 men and 4,981 women) aged ≥20 years from the Sixth Korean National Health and Nutrition Examination Survey VI (2013∼2014) were analyzed. In men, after adjusting for the related variables, the odds ratios (ORs) of HTN [systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or use of HTN medications] were significantly higher in the decreased eGFR group [eGFR ＜60 mL/min/1.73 m2, 1.98 (95% CI, 1.21∼3.24)], elevated ACR group [ACR ≥30 mg/g, 2.03 (95% CI, 1.54∼2.69)], and decreased eGFR plus elevated ACR group [eGFR ＜60 mL/min/1.73 m2 and ACR ≥30 mg/g, 6.03 (95% CI, 2.82∼12.92)] than in the normal group (eGFR ≥60 mL/min/1.73 m2 and ACR ＜30 mg/g). In women, after adjusting for the related variables, the ORs of HTN were significantly higher in the decreased eGFR group (2.29, 95% CI, 1.27∼4.13), elevated ACR group (2.22, 95% CI, 1.68∼2.94), and decreased eGFR plus elevated ACR group (10.77, 95% CI, 3.89∼29.82) than the normal group. In conclusion, HTN was associated with a decreased eGFR and elevated ACR in Korean men and women. In addition, the prevalence of HTN increased greatly when a decreased eGFR and elevated ACR occurred simultaneously.
참고문헌 (37)
- Muntner P, "Renal in-sufficiency and subsequent death resulting from cardiovascular disease in the United States", J Am Soc Nephrol, 13, pp.745~753 (2002)
- Chi Pang Wen, "All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan", The Lancet, 371(9631), pp.2173~2182 (2008), Elsevier BV[DOI]
- Stein I. Hallan, "International Comparison of the Relationship of Chronic Kidney Disease Prevalence and ESRD Risk", Journal of the American Society of Nephrology, 17(8), pp.2275~2284 (2006), American Society of Nephrology (ASN)[DOI]
- Coresh J, "Prevalence of chronic kidney disease in the United States", JAMA, 298, pp.2038~2047 (2007)[DOI]
- National Kidney Foundation, "DOQI clinical practice guide-lines for chronic kidney disease: evaluation, classification, and stratification", Am J Kidney Dis, 39(2 Suppl 1), pp.1~266 (2002)
- Levey AS, "Chronic kidney disease as a global public health problem : ap-proaches and initiatives-a position statement from Kidney Disease Improving Global Outcomes", Kidney Int, 72, pp.247~259 (2007)[DOI]
- Bakris GL, "World Kidney Day Steering Committee : The message for World Kidney Day 2009 : hypertension and kid-ney disease : a marriage that should be prevented", J Clin Hypertens(Greenwich), 11, pp.144~147 (2009)[DOI]
- Coresh J, "Prevalence of high blood pressure and elevated serum crea-tinine level in the United States : findings from the third National Health and Nutrition Examination Survey(1988-1994)", Arch Intern Med, 161, pp.1207~1216 (2001)[DOI]
- Agarwal R, "Prevalence, treatment, and control of hypertension in chron-ic hemodialysis patients in the United States", Am J Med, 115, pp.291~297 (2003)[DOI]
- 안희정, "Urinary Albumin Excretion Reflects Cardiovascular Risk in Postmenopausal Women without Diabetes: The 2011 to 2013 Korean National Health and Nutrition Examination Survey", Endocrinology and Metabolism, 31(4), pp.537~546 (2016), 대한내분비학회
- American Diabetes Association, "9. Cardiovascular Disease and Risk Management", Diabetes Care, 40(Supplement_1), pp.S75~S87 (2017), American Diabetes Association[DOI]
- 기미영, "한국 성인에서 뇨 중 Microalbumin과 맥압의 관련성", 대한임상검사과학회지, 48(3), pp.183~187 (2016), 대한임상검사과학회
- Inker LA, "KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD", Am J Kidney Dis, 63, pp.713~735 (2014)[DOI]
- Andrew S. Levey, "The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report", Kidney International, 80(1), pp.17~28 (2011), Elsevier BV[DOI]
- Levey AS, "Estimating GFR using the CKD epidemiol-ogy collaboration(CKD-EPI)creatinine equation : more accurate GFR estimates, lower CKD prevalence estimates, and better risk predictions", Am J Kidney Dis, 55, pp.622~627 (2010)[DOI]
- Zhang QL, "Prevalence of chronic kidney disease in population-based studies : systematic review", BMC Public Health, 8, pp.117~ (2008)[DOI]
- Chen J, "Prevalence of decreased kidney function in Chinese adults aged 35 to 74 years", Kidney Int, 68, pp.2837~2845 (2005)[DOI]
- Shankar A, "The association among smoking, heavy drinking, and chronic kidney disease", Am J Epidemiol, 164, pp.263~271 (2006)[DOI]
- Marcio G, "Chronic kidney disease and risk factors responsible for sudden cardiac death: a whiff of hope?", Kidney Research and Clinical Practice, 35(1), pp.3~9 (2016), 대한신장학회
- 윤현, "Relationship between the Estimated Glomerular Filtration Rate and the Urine Microalbumin", Creatinine Ratio and Ferritin in Korean Adults, 2019, pp.51(2), 145~154[DOI]
- Vejakama P, "Treatment effects of renin-angiotensin aldosterone sys-tem blockade on kidney failure and mortality in chronic kidney disease patients", BMC Nephrol, 18, pp.342~ (2017)[DOI]
- Lin YP, "Albuminuria in hypertension", Hypertens Res, 36, pp.762~764 (2013)[DOI]
- Renna NF, "Pathophysiology of vas-cular remodeling in hypertension", Int J Hypertens, 2013, pp.808353~ (2013)[DOI]
- Stehouwer CD, "Microalbuminuria and risk for cardiovascular disease : analysis of potential mechanisms", J Am Soc Nephrol, 17, pp.2106~2111 (2006)[DOI]
- Ruiz-Hurtado G, "Association between high and very high albuminuria and nighttime blood pressure : influence of dia-betes and chronic kidney disease", Diabetes Care, 39, pp.1729~1737 (2016)[DOI]
- Wang K, "Effects of an-giotensin-converting enzyme inhibitors and angiotensin II re-ceptor blockers on all-cause mortality and renal outcomes in pa-tients with diabetes and albuminuria : a systematic review and meta-analysis", Kidney Blood Press Res, 43, pp.768~779 (2018)[DOI]
- Lee HF, "End-stage renal disease patients using angiotensin-converting enzyme in-hibitors and angiotensin receptor blockers may reduce the risk of mortality : a Taiwanese nationwide cohort study", Intern Med J, 48, pp.1123~1132 (2018)[DOI]
- Agodoa LY, "Effect of ramipril vs amlodipine on renal outcomes in hy-pertensive nephrosclerosis : a randomized controlled trial", JAMA, 285, pp.2719~2728 (2001)[DOI]
- Zheng CM, "Angiotensin-converting enzyme inhibitors or angiotensin re-ceptor blocker monotherapy retard deterioration of renal func-tion in Taiwanese chronic kidney disease population", Sci Rep, 9, pp.2694~ (2019)[DOI]
- Said S, "The link between chronic kidney disease and cardiovascular disease", J Nephropathol, 3, pp.99~104 (2014)[DOI]
- Alonso A, "Chronic kidney disease is associated with the incidence of atrial fibrillation : the atherosclerosis risk in communities(ARIC)study", Circulation, 123, pp.2946~2953 (2011)[DOI]
- Matthew Nayor, "The association of chronic kidney disease and microalbuminuria with heart failure with preserved vs. reduced ejection fraction", European Journal of Heart Failure, 19(5), pp.615~623 (2017), Wiley[DOI]
- Guh JY, "Proteinuria versus albuminuria in chronic kidney disease", Nephrology(Carlton), 15(Suppl 2), pp.53~56 (2010)[DOI]
- Arnlöv J, "Low-grade albuminuria and incidence of cardiovascular disease events in nonhypertensive and nondiabetic individuals : the Framingham Heart Study", Circulation, 112, pp.969~975 (2005)[DOI]
- Gerstein HC, "Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals", JAMA, 286, pp.421~426 (2001)[DOI]
- Viazzi F, "Microalbuminuria is a predictor of chronic renal in-sufficiency in patients without diabetes and with hypertension : the MAGIC study", Clin J Am Soc Nephrol, 5, pp.1099~1106 (2010)[DOI]
- van der Velde M, "Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and car-diovascular mortality. A collaborative meta-analysis of high-risk population cohorts", Kidney Int, 79, pp.1341~1352 (2011)[DOI]