The risk of diabetic renal function impairment in the first decade after diagnosed of diabetes mellitus is correlated with high variability of visit-to-visit systolic and diastolic blood pressure: a case control study

BMC Nephrology

Research Article

Hsiu-Chin Yu¹  Tzu-Yen Huang²  Tzu-Ping Chen²  Shun-Ying Yin²  Yao-Chang Wang²  Pin-Fu Huang²  Chi-Hsiao Yeh³ 

[1]Department of Nursing, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China

[2]Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, 222 Mai-Chin Road, 204, Keelung, Taiwan, Republic of China

[3]Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, 222 Mai-Chin Road, 204, Keelung, Taiwan, Republic of China

[4]College of Medicine, Chang Gung University, Tao-Yuan, Taiwan, Republic of China

[5]Division of Thoracic & Cardiovascular Surgery, Chang Gung Memorial Hospital, 222 Mai-Chin Road, 204, Keelung, Taiwan

关键词: Blood pressure control;    Chronic kidney disease;    Electronic medical record;    Hypertension;   

DOI  :  10.1186/s12882-017-0514-9

 received in 2016-10-11, accepted in 2017-03-15,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe variability of visit-to-visit (VVV) in systolic blood pressure (SBP) and diastolic blood pressure (DBP) is proved as a predictor of renal function deterioration in patients with non-diabetic chronic kidney disease. The purpose of this study was to investigate the relationship of the variability in SBP and the magnitude of renal function impairment for normal renal function patients in the first 10-years diagnosed with type II diabetes mellitus (DM).MethodsWe retrospectively reviewed the electronic medical records of 789 patients who were first diagnosed with diabetes mellitus during 2000–2002 and regularly followed for 10 years with a total of 53,284 clinic visits. The stages of Chronic Kidney Disease (CKD) of every patient were determined using estimated glomerular filtration rate. The occurrence of nephropathy was defined in those patients whose CKD stages elevated equal or larger than three.ResultsPatients were categorized according to the VVV of systolic and diastolic BP into three groups. Patients with high VVV of both SBP and DBP had a 2.44 fold (95% CI: 1.88–3.17, p < 0.001) increased risk of renal function impairment compared with patients with low VVV of both SBP and DBP. Risk of renal function impairment for patients with high VVV of either SBP or DBP had a 1.43-fold increase (95% CI: 1.08–1.89, p = 0.012) compared with patients with low VVV of both SBP and DBP. Cox regression analysis also demonstrated that every 1-year increase of DM diagnosed age significantly raised the risk of renal function impairment with a hazard ration of 1.05 (95% CI: 1.04–1.06, p < 0.001).ConclusionsNot only VVV of SBP but also VVV in DBP is correlated with diabetic nephropathy in the first decade for patients diagnosed with type 2 DM.

【 授权许可】

CC BY   
© The Author(s). 2017