Ambulatory blood pressure as risk factor for long-term kidney function decline in the general population: a distributional regression approach
Abstract The results of randomized controlled trials are unclear about the long-term effect of blood pressure (BP) on kidney function assessed as the glomerular filtration rate (GFR) in persons without chronic kidney disease or diabetes. The limited duration of follow-up and use of imprecise methods...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-41181-7 |
| _version_ | 1797452660669939712 |
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| author | Bjørn O. Eriksen Matteo Fasiolo Ulla D. Mathisen Trond G. Jenssen Vidar T. N. Stefansson Toralf Melsom |
| author_facet | Bjørn O. Eriksen Matteo Fasiolo Ulla D. Mathisen Trond G. Jenssen Vidar T. N. Stefansson Toralf Melsom |
| author_sort | Bjørn O. Eriksen |
| collection | DOAJ |
| description | Abstract The results of randomized controlled trials are unclear about the long-term effect of blood pressure (BP) on kidney function assessed as the glomerular filtration rate (GFR) in persons without chronic kidney disease or diabetes. The limited duration of follow-up and use of imprecise methods for assessing BP and GFR are important reasons why this issue has not been settled. Since a long-term randomized trial is unlikely, we investigated the association between 24-h ambulatory BP (ABP) and measured GFR in a cohort study with a median follow-up of 11 years. The Renal Iohexol Clearance Survey (RENIS) cohort is a representative sample of persons aged 50 to 62 years without baseline cardiovascular disease, diabetes, or kidney disease from the general population of Tromsø in northern Norway. ABP was measured at baseline, and iohexol clearance at baseline and twice during follow-up. The study population comprised 1589 persons with 4127 GFR measurements. Baseline ABP or office BP components were not associated with the GFR change rate in multivariable adjusted conventional regression models. In generalized additive models for location, scale, and shape (GAMLSS), higher daytime systolic, diastolic, and mean arterial ABP were associated with a slight shift of the central part of the GFR distribution toward lower GFR and with higher probability of GFR < 60 mL/min/1.73 m2 during follow-up (p < 0.05). The use of a distributional regression method and precise methods for measuring exposure and outcome were necessary to detect an unfavorable association between BP and GFR in this study of the general population. |
| first_indexed | 2024-03-09T15:11:51Z |
| format | Article |
| id | doaj.art-8530a213f710409e94c5a048e6b6127b |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-09T15:11:51Z |
| publishDate | 2023-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-8530a213f710409e94c5a048e6b6127b2023-11-26T13:20:46ZengNature PortfolioScientific Reports2045-23222023-08-0113111410.1038/s41598-023-41181-7Ambulatory blood pressure as risk factor for long-term kidney function decline in the general population: a distributional regression approachBjørn O. Eriksen0Matteo Fasiolo1Ulla D. Mathisen2Trond G. Jenssen3Vidar T. N. Stefansson4Toralf Melsom5Metabolic and Renal Research Group, UiT The Arctic University of NorwaySchool of Mathematics, University of BristolMetabolic and Renal Research Group, UiT The Arctic University of NorwayMetabolic and Renal Research Group, UiT The Arctic University of NorwayMetabolic and Renal Research Group, UiT The Arctic University of NorwayMetabolic and Renal Research Group, UiT The Arctic University of NorwayAbstract The results of randomized controlled trials are unclear about the long-term effect of blood pressure (BP) on kidney function assessed as the glomerular filtration rate (GFR) in persons without chronic kidney disease or diabetes. The limited duration of follow-up and use of imprecise methods for assessing BP and GFR are important reasons why this issue has not been settled. Since a long-term randomized trial is unlikely, we investigated the association between 24-h ambulatory BP (ABP) and measured GFR in a cohort study with a median follow-up of 11 years. The Renal Iohexol Clearance Survey (RENIS) cohort is a representative sample of persons aged 50 to 62 years without baseline cardiovascular disease, diabetes, or kidney disease from the general population of Tromsø in northern Norway. ABP was measured at baseline, and iohexol clearance at baseline and twice during follow-up. The study population comprised 1589 persons with 4127 GFR measurements. Baseline ABP or office BP components were not associated with the GFR change rate in multivariable adjusted conventional regression models. In generalized additive models for location, scale, and shape (GAMLSS), higher daytime systolic, diastolic, and mean arterial ABP were associated with a slight shift of the central part of the GFR distribution toward lower GFR and with higher probability of GFR < 60 mL/min/1.73 m2 during follow-up (p < 0.05). The use of a distributional regression method and precise methods for measuring exposure and outcome were necessary to detect an unfavorable association between BP and GFR in this study of the general population.https://doi.org/10.1038/s41598-023-41181-7 |
| spellingShingle | Bjørn O. Eriksen Matteo Fasiolo Ulla D. Mathisen Trond G. Jenssen Vidar T. N. Stefansson Toralf Melsom Ambulatory blood pressure as risk factor for long-term kidney function decline in the general population: a distributional regression approach Scientific Reports |
| title | Ambulatory blood pressure as risk factor for long-term kidney function decline in the general population: a distributional regression approach |
| title_full | Ambulatory blood pressure as risk factor for long-term kidney function decline in the general population: a distributional regression approach |
| title_fullStr | Ambulatory blood pressure as risk factor for long-term kidney function decline in the general population: a distributional regression approach |
| title_full_unstemmed | Ambulatory blood pressure as risk factor for long-term kidney function decline in the general population: a distributional regression approach |
| title_short | Ambulatory blood pressure as risk factor for long-term kidney function decline in the general population: a distributional regression approach |
| title_sort | ambulatory blood pressure as risk factor for long term kidney function decline in the general population a distributional regression approach |
| url | https://doi.org/10.1038/s41598-023-41181-7 |
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