Observational studyJournal of nephrology2020
Aortic stiffness and central systolic pressure are associated with ambulatory orthostatic BP fall in chronic kidney disease.
Observational study in Journal of nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Association between arterial stiffness and orthostatic hypotension: A systematic review and meta-analysis.Frontiers in physiology · 2023Pooled it
- Functional status associated with postural dizziness, but not postural hypotension, in older adults: a community-based study.BMC geriatrics · 2023Trial
- Clinical Epidemiology of Systolic and Diastolic Orthostatic Hypotension in Patients on Peritoneal Dialysis.Journal of clinical medicine · 2021Article
- Narrative Review of Carotid disease and the kidney.Annals of translational medicine · 2021Review
- Addressing Orthostatic Hypotension in Heart Failure: Pathophysiology, Clinical Implications and Perspectives.Journal of cardiovascular translational research · 2020Review
- C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke.Frontiers in immunology · 2020Article
- Orthostatic Hypertension and Hypotension and Outcomes in CKD: The CRIC (Chronic Renal Insufficiency Cohort) Study.Kidney medicineArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveOrthostatic hypotension (OH) has a significant association with cardiovascular disease. OH becomes more common in older age, as does arterial stiffness, shown to be independently associated with impaired baroreflex sensitivity and OH. Measurement of arterial compliance and central blood pressures are increasingly important, with evidence that central BP more closely correlates to end-organ damage and mortality than peripheral measurements. Patients with chronic kidney disease (CKD) are high risk for cardiovascular events, which can be predicted through measures of arterial compliance. We hypothesised that OH is associated with arterial stiffness and central blood pressure in CKD patients. DESIGN/
settingWe tested this hypothesis within the arterial compliance and oxidant stress as predictors of loss of renal function, morbidity and mortality in chronic kidney disease (ACADEMIC) study, a single-centre prospective observational study of the progression of arterial stiffness and renal function.
participantsOne hundred and forty-six patients with CKD 3 or 4. MEASUREMENTS: Twenty-four-hour ambulatory BP monitoring with postural sensing (DIASYS Integra 2, Novacor France); central systolic and diastolic BP (cSBP and cDBP) and aortic Augmentation Index using Sphygmocor
resultsTwenty-three patients had a postural SBP fall (prevalence 15.8%), with mean drop 7 mmHg. Patients with OH had higher cfPWV (15.2 m/s vs 12.7 m/s in patients without OH, p < 0.001) and central SBP (147.5 vs 135.7, p = 0.012). Regression analysis gave an odds ratio (OR) of orthostatic SBP fall for cfPWV of 1.46 (95% CI 1.16-1.84, p = 0.001) and 1.03 for cSBP (95% CI 1.004-1.06, p = 0.024) after adjustment for cardiovascular risk factors.
conclusionAortic stiffness and central SBP are independently associated with orthostatic SBP fall in CKD patients. This suggests that enhanced arterial stiffness may be an underlying mechanism in baroreflex dysfunction, and may partly explain the vascular risk in CKD patients.
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