Electrolyte Blood Press.  2019 Dec;17(2):54-61. 10.5049/EBP.2019.17.2.54.

Baseline High Blood Pressure is Associated with Clinico-Pathologic Findings and Later Renal Progression in Chronic Glomerulonephritis

• Lee JY
• Ihm HS
• Kim JS
• Hwang HS
• Jeong KH
• Ihm CG

• KMID: 2467961
• DOI: http://doi.org/10.5049/EBP.2019.17.2.54

Abstract

BACKGROUND
Several factors had been suggested to contribute to the development of hypertension in chronic glomerulonephritis (GN). This study was conducted to find the association of baseline blood pressure (BP) with pathophysiologic findings and later renal progression in chronic GN.
METHODS
Clinico-pathological findings including serum creatinine (Cr), proteinuria, pathological findings, and urinary Na excretion were analyzed in a total of 233 patients with IgA nephropathy from The Kyung-Hee Cohort of GN. Glomerular surface area (GSA) was measured by imaging analysis and urine angiotensinogen (AGT) concentrations by human ELISA kits.
RESULTS
Systolic BP was ≥130mmHg in 124 patients (53%). Systolic BP was negatively correlated with follow-up eGFR (r=−0.32, p<0.0001) and positively serum uric acid concentrations, while it had no significant relationships with initial serum Cr and eGFR. As compared with patients with systolic BP<130 mmHg, those with ≥130 mmHg were older and showed higher serum Cr, proteinuria, 24 hr urinary Na excretion, mean GSA, and T-I fibrosis, lower follow-up eGFR, and steeper decline in slope of eGFR. The results in patients with normal serum Cr concentrations were comparable to those in whole group. Systolic BP was positively correlated with age, baseline and follow-up proteinuria, serum uric acid concentrations and IgM deposit and negatively with follow-up eGFR. In subgroup analysis, systolic BP was also positively correlated with mean GSA and urinary AGT concentrations.
CONCLUSION
This study showed that baseline systolic BP is related to urinary Na excretion, glomerulomegaly, T-I fibrosis and later renal progression in patients with IgA nephropathy.

Keyword

Blood pressure; eGFR; Na excretion; Angiotensinogen; Pathology; Glomerulomegaly; Progression

MeSH Terms

Angiotensinogen
Blood Pressure
Cohort Studies
Creatinine
Enzyme-Linked Immunosorbent Assay
Fibrosis
Follow-Up Studies
Glomerulonephritis*
Glomerulonephritis, IGA
Humans
Hypertension*
Immunoglobulin M
Pathology
Proteinuria
Uric Acid
Angiotensinogen
Creatinine
Immunoglobulin M
Uric Acid

Figure

• 

  Fig. 1 Relationships between systolic BP and the follow-up eGFR. BP, blood pressure; CI, confidence interval; eGFR, estimated glomerular filtration rate.

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