| Title: | Determining the Relationship Between Blood Pressure, Kidney Function, and Chronic Kidney Disease: Insights From Genetic Epidemiology |
| Journal: | Hypertension |
| Published: | 9 Sep 2022 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/36082669/ |
| DOI: | https://doi.org/10.1161/hypertensionaha.122.19354 |
| URL: | https://ora.ox.ac.uk/objects/uuid:aefe90da-8a81-4cfa-981a-bb36eca6faa3/files/r6w924c60k |
| Citations: | 10 (9 in last 2 years) as of 8 Aug 2024 |
Publication 12240
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BACKGROUND: It is well established that decreased kidney function can increase blood pressure (BP), but it is unproven whether moderately elevated BP causes chronic kidney disease (CKD) or glomerular hyperfiltration.</p>
METHODS: 311 119 White British UK Biobank participants were included in logistic regression analyses to estimate the odds of CKD (defined as long-term kidney replacement therapy, estimated glomerular filtration rate [eGFR]< 60mL/min/1.73m2, or urinary albumin:creatinine ratio ≥3 mg/mmol) associated with higher genetically predicted BP using genetic risk scores comprising 219 systolic and 223 diastolic BP loci. Analyses estimating associations with clinical categories of eGFR and urinary albumin:creatinine ratio were also conducted, with an eGFR ≥120 mL (min·1.73m2) considered evidence of glomerular hyperfiltration.</p>
RESULTS: 21 623 participants had CKD: 7781 with reduced eGFR and 15 500 with albuminuria. 1828 participants had an eGFR ≥120 mL/min/1.73m2. Each genetically predicted 10 mmHg higher systolic BP and 5 mmHg higher diastolic BP were associated with a 37% (95% CI, 1.29-1.45) and 19% (1.14-1.25) higher odds of CKD, respectively. Associations were evident for both the reduced eGFR and albuminuria components of the CKD outcome. The odds of hyperfiltration (versus an eGFR ≥60 and <90 mL/min/1.73m2 were 49% higher (95% CI, 1.21-1.84) for each genetically predicted 10 mmHg higher systolic BP. Associations with CKD and hyperfiltration were similar irrespective of preexisting diabetes, vascular disease, or different levels of adiposity.</p>
CONCLUSIONS: In this general population, genetic epidemiological evidence supports a causal role of life-long differences in BP for decreased kidney function, glomerular hyperfiltration, and albuminuria. Physiological autoregulation may not afford complete renal protection against the moderate BP elevations.</p>
14 Authors
- Natalie Staplin
- William G. Herrington
- Federico Murgia
- Maysson Ibrahim
- Katherine R. Bull
- Parminder K. Judge
- Sarah Y.A. Ng
- Michael Turner
- Doreen Zhu
- Jonathan Emberson
- Martin J. Landray
- Colin Baigent
- Richard Haynes
- Jemma C. Hopewell
1 Application
| Application ID | Title |
|---|---|
| 15595 | Renal Studies Group and Population Studies Group, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health (NDPH), University of Oxford |
Enabling scientific discoveries that improve human health