bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMPACT OF PERCUTANEOUS TRANSLUMINAL RENAL ANGIOPLASTY ON LEFT VENTRICULAR MASS AND ITS RELATIONSHIP TO CARDIOVASCULAR OUTCOME IN HYPERTENSIVE PATIENTS WITH RENAL ARTERY STENOSIS
Authors: Iwashima Yoshio , Fukuda Tetsuya , Horio Takeshi , Kusunoki Hiroshi , Hayashi Shin-Ichiro , Kamide Kei , Kawano Yuhei , Yoshihara Fumiki , Ishimitsu Toshihiko 
Published: April 2021

Objective:
Renal artery stenosis (RAS) is associated with secondary hypertension, which is often resistant to antihypertensive medication.The aim of the present study was to evaluate the impact of renal angioplastry on left ventricular (LV) mass, as measured by echocardiography, and further to determine whether LV mass reduction is associated with reduced rates of cardiovascular events in hypertensive patients with RAS.

Design and method:
A total of 144 hypertensive patients with RAS (mean age 69 years; 22.2% fibromuscular dysplasia [FMD]) who underwent angioplasty were included. Echocardiography was performed at baseline and after one year, and were thereafter followed up for a median of 5.6 years for the primary composite outcomes. The primary endpoint of this study was first occurrence of the composite of cardiovascular events including all-cause death, myocardial infarction, stroke, or adverse aortic event.

Results:
In both the FMD and atherosclerotic stenosis (ARAS) groups, LV mass decreased after angioplasty, but the decrease in LV mass index (-15.4 ± 18.3% versus -0.8 ± 27.8%, p < 0.01) as well as the regression rate of LV hypertrophy was greater in FMD. Multiple logistic regression analysis indicated that FMD (odds ratio [OR] 2.94, p < 0.01), severe RAS (greater than or equal to 90%) (OR 2.94, p < 0.05), and higher LV mass index at baseline (OR 2.94 for 1 standard deviation increase, p < 0.001) were independent predictors of LV mass index decrease of at least 20%. The primary composite outcomes occurred in 45 patients (31.3%). In FMD, lower LV mass index after one year (hazard ratio 2.81 for 1 standard deviation increase, p < 0.05) or regression of LV mass (hazard ratio 0.75 for 5% decrease, p = 0.054) showed a tendency to be associated with better outcomes; however, these associations were not found in ARAS.

Conclusions:
Hypertensive patients with ARAS have less regression of LV mass in response to angioplasty than those with FMD, and LV mass regression is less useful as a surrogate marker of outcomes especially in ARAS.
EARLY RENAL DAMAGE IN YOUNG HYPERTENSIVE SUBJECTS: LINK WITH OFFICE AND 24-HOUR AMBULATORY SYSTOLIC AND DIASTOLIC BLOOD PRESSURE
Authors: Ezhova Nadezhda , Khomova Irina , Shavarova Elena , Bazdyreva Elena , Kobalava Zhanna 
Published: April 2021

Objective:
Hypertension (HTN) and target organ damage rate in young subjects is underestimated in clinical practice according to latest population studies and treatment strategy of HTN is not well defined due to minor and controversial data of clinical studies. As a part of cohort study of HTN detection and evaluation in young population we investigated renal function in untreated hypertensive subjects with primary diagnosed essential hypertension.

Design and method:
We performed office BP evaluation and ambulatory blood pressure monitoring with oscillometric cuff-based device in 102 young subjects with untreated essential hypertension defined with ESH criteria of HTN according to office and ambulatory blood pressure monitoring (age 26.2 ± 7.7 (M ± SD) years, 88.3% male, office SBP 134.7 ± 15.8 mm Hg, office DBP 73.2 ± 12.4 mm Hg). Serum creatinine and albumin/creatinine ratio in urine were measured. GFR was calculated with CKD-EPI. For comparison of variables in quartiles of blood pressure we used one-way ANOVA for parametric ones and Kruskal-Wallis test – for non-parametric variables.

Results:
We compared glomerular filtration rate (GFR) and albumin/creatinine ratio (ACR) in quartiles of office and 24 h systolic and diastolic blood pressure. Significant difference in GFR was registered in office SBP quartiles: GFR in 1st and 4th quartiles was 105,1 ± 21,7 vs 90,3 ± 14 ml/min/1,73m2, with F 4.035, P value 0,0097 while there was no any significant difference of ACR levels according to office BP levels. ACR was significantly different in quartiles of mean nighttime DBP: ACR median in 1st quartile – 4 [0,75; 5,0] vs 8 [3,0; 29,0] in last quartile, P value 0,0056 with no significant difference for daytime DBP and daytime and nighttime SBP. Significant correlation between mean nighttime DBP and ACR was observed: r 0,243, P value 0,023. R for office SBP and GFR was (-0,325) with P value 0,002.

Conclusions:
In young untreated hypertensive subjects elevation of office SBP is associated with GFR decline while ACR has association with nighttime DBP elevation.
SEX, METABOLIC AND PHARMACOLOGICAL MODULATORS OF SODIUM HANDLING IN POPULATION WITH PREVAILING SODIUM INTAKE
Authors: Cwynar Marcin , Stolarz-Skrzypek Katarzyna , Gasowski Jerzy , Gryglewska Barbara , Wojciechowska Wiktoria , Olszanecka Agnieszka , Dzieza Anna , Bednarski Adam , Barton Henryk , Czarnecka Danuta , Grodzicki Tomasz 
Published: April 2021

Objective:
Renal sodium handling is associated with sex, ethnic, central adiposity and hypertensive treatment.

Design and method:
In a sample of caucasian population without diuretic treatment (351 subjects) with prevailing sodium consumption (153,6 mmol/d), we studied the associations between renal sodium reabsorption in proximal (FPRNa) and distal (FDRNa) tubules assessed by endogenous lithium clearance, daily sodium intake measured by 24-h excretion of sodium (UNaV) and measures of obesity in the context of chronic treatment with ACEI or ARB.

Results:
In the entire population in linear regression model, we found a relation between sex and FPRNa (β = 1.06 ± 0.30, P = 0.0005), with higher sodium reabsorption in proximal tubules in men. In subjects with FPRNa below the median value, we displayed a significant reverse relation between FPRNa and ACEI/ARB treatment (β = -0.40 ± 0.18, P = 0.03) with no relation for BMI (P = 0.42). Contrary, in subjects with FPRNa above the median value, a significant positive relation between FPRNa and BMI (β = 0.10 ± 0.03, P = 0.004) was revealed, with no relation for ACEI/ARB treatment (P = 0.55). For FDRNa (P > 0.10) and UNaV (P > 0.06) we found no relation for ACE/ARB treatment in entire population and after divided by median.

Conclusions:
We found that sex, obesity and chronic treatment with ACEI/ARB influence sodium reabsorption in renal proximal tubules. This may impact both on the research and clinical practice.
DRUG RELATED PROBLEMS AND ASSOCIATED FACTORS AMONG PATIENTS SUFFERING FROM CHRONIC KIDNEY DISEASE IN HYDERABAD
Authors: Shaheen Sumera 
Published: April 2021

Objective:
To analyze the occurrence of medication related problems and associated factors among patients suffering from chronic kidney disease in Hyderabad, Pakistan.

Design and method:
The prospective and observational study was conducted among 103 patients who had confirmed diagnosis of chronic kidney disease based on GFR from April to September 2019. Data related with the patient's demographic details, medications, diagnosis and other necessary information were collected through patient's medications profiles. Data was analyzed by using M.S Excel and (SPSS) version 21.0.

Results:
Out of 103 patients, 79 (76.69%) had MRPs. The rate of whole MRPs was 32.90 %. The most common MRPs among CKD patients were non-adherence (31%), dose too low (18%) and need of drug additional therapy (18%). The most common cause of need of additional drug therapy (24%) was those medical conditions which were untreated non-adherence 8.5% was mostly due to the forgetfulness of either the patient or his caregiver.

Conclusions:
The current study revealed that Medications related problems are high among CKD patients due to creatinine clearance and all the health care professionals should work for lowering down it.
DOES MICROANGIOPATHY INFLUENCE ARTERIAL PRESSURE IN IGA NEPHROPATHY?
Authors: Mannai Khouloud , Hajri Malika , Gaied Hanene , Jerbi Mouna , Harzallah Amel , Bacha Mouhamed Mongi , Trabelsi Raja , Lounissi Mondher , Barbouch Samia , Hedri Hafedh , Kaaroud Hayet , Laabidi Jannet , Abderrahim Ezzeddine , Hmida Fathi Ben , Younsi Fethi El , Goucha Rym , Abdallah Taieb Ben 
Published: April 2021

Objective:
This study aimed to establish clinical particularities of patients with primitive IgA nephropathy (IgAN) in case of associated thrombotic microangiopathy (TMA); comparatively with patients without TMA.

Design and method:
We compared two groups of patients diagnosed with primitive IgAN, from 1995 to 2017. The group1 (G1) comprised all patients with at least one TMA lesion in their renal biopsy. The group 2 (G2) was a randomly chosen sample of patients without TMA. Inclusion criteria were: patients older than 16, and followed up by our team. Exclusion criteria were: secondary IgAN or IgA vascularites, incomplete files and inconclusive IF results. We collected the initial clinical parameters. Then, using the “U” test of Mann-Witney test, we compared the two groups.

Results:
We selected 50 patients for G1 and 74 patients for G2. Baseline characters of all subjects were: mean age 33, men to women ratio 1.95, mean BMI 24.6 [17–38], mean albuminemia 33 [8–53] g/l, median serum creatinine (SCr) 207 [49–1800]μmol/l, mean eGFR 47 [2–156] ml/min and mean proteinuria 2.9 [0–11] g/day. Mean systolic and diastolic pressure were 139 [90–200] and 85 [50–120] mmHg. Seventy two patients (58%) had hypertension: grade 1, grade 2 and grade 3 for 23.4%, 23.4% and 11.3%. Comparing the two groups (G1 vs G2) the difference was significant for: systolic pressure (p = 0.000, 155 vs 128 mmHg), diastolic pressure (p = 0.000, 93 vs 79 mmHg), hypertension frequency (p = 0.000, 96% vs 32%), grade 2 hypertension (p = 0.000, 38% vs 13.5%), grade 3 hypertension (p = 0.000, 24% vs 2.7%) and SCr (p = 0.000, 501 vs 231 μmol/l). There was no significant difference forage (p = 0.10), BMI (p = 0.26), albuminemia (p = 0.14) and proteinuria (p = 0.059).

Conclusions:
Founding a TMA lesion in our patients’ biopsies should alert us to a more severe form of IgAN, with a more frequent hypertension and more advanced renal failure.
MAJOR CORRELATIVE RISK FACTORS OF CHRONIC KIDNEY DISEASE AND CO-MORBIDITIES IN PAKISTAN
Authors: Ali Muhammad 
Published: April 2021

Objective:
End-stage kidney disease or chronic kidney disease is an alarming and major public health problem. Its multi factorial reasons such as insufficient and lack of health related wakefulness, and most important the high burden of co-morbidity such as age, diabetes, cardiovascular, peripheral vascular, and hepatic disease add-on kidney diseases, makes these observations knotty to interpret.
Chronic kidney disease is progressive loss of half or more than half of normal kidney and risk of adverse outcomes has been increase day by day. This study was used to consider the frequency of kidney disease and to determine its association with avoidable factors of risk such as Diabetes & Hypertension. The main purpose of this study was to evaluate the incidence and clinical factors linked with kidney diseases.

Design and method:
A descriptive study was performed on 300 participants aged above than 40 years in five clinical setup of Hyderabad, Pakistan. This study was carried out from March to December 2019. A special proforma was formed to gather the data. Routine following information was collected e.g diet routine & physical activity, smoking status, co-morbidities, Serum level of creatinine and glomerular filtration rate was checked by using the kidney diseases epidemiology collaboration equation.

Results:
Results show that the overall prevalence of kidney disease was 24.7%. 97% had their serum creatinine checked. Among them, 62.4% had GFR >90, 19.8 were in chronic kidney disease stage 2 with eGFR 60–89, and 8.9% in Chronic kidney problem stage 3 with eGFR 30–59. Chronic kidney disease patients were notably older, performed limited physically actives, have diabetes, high blood pressure, heart disease & stroke as compared to other. A strong association was reported between kidney disease & hyperglycaemia & hypertension. 71.3% patients with diabetes were found during study.

Conclusions:
It shows that a kidney disease is more common in Pakistani population. The high risk factors & poor management of diabetes & hypertension among patients with kidney disease emphasize the need to provide kidney disease awareness, management & prevention in the primary care services in Pakistan.
SODIUM-GLUCOSE CO-TRANSPORTER-2 INHIBITORS ARE PROTECTIVE AGAINST ACUTE KIDNEY INJURY ACROSS THE CARDIOVASCULAR AND RENAL OUTCOME TRIALS: AN UPDATED META-ANALYSIS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Stavropoulos Konstantinos , Imprialos Konstantinos , Toumpourleka Maria , Kalogirou Maria-Styliani , Koutsampasopoulos Konstantinos , Tegou Zoi , Mavridou Maria , Siskos Fotios , Papadopoulos Christodoulos , Doumas Michael 
Published: April 2021

Objective:
Acute kidney injury (AKI) has a significant prognostic impact on chronic kidney disease development and progression, cardiovascular morbidity and mortality and all-cause mortality both in the in-hospital and in the outpatient setting. Initial concerns of increased risk of AKI with the use of sodium-glucose co-transporter-2 (SGLT-2) inhibitors have partially limited their broad use.

Design and method:
We searched PubMed from its inception to 28 September 2020. We sought to determine the effect of SGLT-2 inhibitors on AKI regardless of diabetes status across the hallmark cardiovascular and renal outcome trials. No efficacy outcomes were assessed.

Results:
Besides trialists of the EMPEROR-Reduced trial who did not report any data regarding the incidence of AKI in the two treatment arms, the rest cardiovascular and renal outcome trials provided corresponding data. Therefore, we pooled available data from seven randomized controlled trials in a total of 55,966 enrolled participants. SGLT-2 inhibitor treatment resulted in a significant decrease in the risk of AKI equal to 25% (RR = 0.75, 95% CI; 0.66 to 0.85, I2 = 0%). The observed effect was primarily driven by the cardiovascular outcome trials (RR = 0.71, 95% CI; 0.61 to 0.83, I2 = 0%), while, no significant effect was observed in the dedicated renal outcome trials (RR = 0.83, 95% CI; 0.66 to 1.05, I2 = 0%).

Conclusions:
The observed protective effect of SGLT-2 inhibitors against AKI in the high or very high risk patients enrolled in the published cardiovascular and renal outcome trials is very important and should influence decision making.
COMPARISON OF SYSTEMIC ARTERIAL STIFFNESS IN PATIENTS WITH NEW DIAGNOSED IDIOPATHIC PULMONARY AND SYSTEMIC ARTERIAL HYPERTENSION
Authors: Radchenko Ganna , Zhyvylo Irina , Titov Eugeniy , Sirenko Yuriy 
Published: April 2021

Objective:
This study is the first attempt to use cardio-ankle vascular index (CAVI) for evaluation of systemic arterial stiffness in patients with idiopathic pulmonary arterial hypertension (IPAH).

Design and method:
45 patients with IPAH, 32 patients with arterial hypertension (AH), 35 healthy persons adjusted by age were included in study. RHC, ECG, 6 minute walk test (6 MWT), echocardiography, blood pressure (BP) measurement and ambulatory BP monitoring, pulse wave elastic artery stiffness (PWVe) and muscular artery stiffness (PWVm), CAVI, NT-proBNP level were provided. The Spearman correlation, a linear regression and multivariable binary logistic analysis were performed to indicate the predictors associated with PWV and CAVI.

Results:
IPAH patients had significant (P < 0.001) shorter 6MWT distance and higher Borg dyspnea score than patients with AH (systolic/diastolic BP- 146.1 ± 3.7/94.2 ± 3.8mmHg) and control group - 330.2 ± 14.6 vs 523.8 ± 35.3 and 560.9 ± 30.2m respectively and 6.2 ± 1.8 vs 1.2 ± 2.1 and 0.9 ± 2.8 points. The PWVm and PWVe were highest in hypertensive patients - 10.3 ± 1.5 and 11.42 ± 1.70m/s. The control group and IPAH did not have significant differences in aorta BP, but PWVm/PWVe values were significant (P < 0.003/0.008) higher in IPAH patients, than in control group - 8.1 ± 1.9/8.49 ± 1.92vs6.63 ± 1.34/7.29 ± 0.87m/s. The CAVIs on both sides were significant lower in healthy subjects (5.91 ± 0.99/5.98 ± 0.87 right/left side). Patients with IPAH did not differ from AH patients by CAVIs in comparison with control group - 7.40 ± 1.32/7.22 ± 1.32vs7.19 ± 0.78/7.2 ± 1.1. PWVe did not correlate with any parameters except uric acid. PWVm correlated with uric acid (r = 0.58, P < 0.001), NT-proBNP (r = 0.33, P = 0.03) and male gender (r = 0.37, P = 0.013) at Spearman analysis, but not at multifactorial linear regression analysis. Unlike the CAVI correlated with age and parameters characterized functional capacity (6 MWT distance) and right ventricle function (NT-proBNP, TAPSE) at Spearman analysis and with age and TAPSE at multifactorial linear regression analysis. At binary logistic regression analysis CAVI > 8.0 at right or/and left side had correlation with age, 6MWT distance, TAPSE, but independent correlation was only with age (beta = 1.104,P = 0.008) and TAPSE (beta = 0.66,P = 0.016).

Conclusions:
Patients with IPAH had significant stiffer arteries than healthy persons and they were comparable with AH patients. Arterial stiffness evaluated by CAVI correlated with age and TAPSE in IPAH patients.
AMBULATORY BLOOD PRESSURE PHENOTYPES, VASCULAR INFLAMMATION AND ARTERIAL STIFFNESS IN ESSENTIAL HYPERTENSION
Authors: Mahmud Azra , Alahaideb Ruba , Alshammary Haifa , Alfawwaz Afnan , Abanumay Mayar , Alhelabi Sara , Alonazy Amgad , Al-Zaibag Muayed 
Published: April 2021

Objective:
Hypertension is the leading risk factor for cardiovascular(CV) disease worldwide. Ambulatory blood pressure(ABPM) is the gold standard for the management of hypertension and its various phenotypes may provide prognostic information beyond clinic blood pressure (BP). The aim was to study the prevalence of various ABPM phenotypes and their relationship with target organ damage(TOD) i.e., urine albumin-creatinine ratio (ACR), and arterial stiffness as pulse wave velocity (PWV)vascular inflammation as high-sensitivity C-reactive protein(hs-CRP) in a Saudi hypertensive population.

Design and method:
We studied consecutive patients aged > 18 yr-old referred to the Hypertension Clinic at King Abdul Aziz Cardiac Center, Riyadh, Saudi Arabia. ABPM was performed for a 24 hour period with an oscillometric device. Masked uncontrolled hypertension (MUCH) was defined as controlled clinic BP with daytime elevated BP (definition-1); 24-hr ambulatory BP (definition-2); and either daytime or nighttime elevated BP (definition-3). Dipping was defined as a 10–20% fall in nocturnal BP; reverse-dipping as less than 0% and extreme dipping as more than 20%. The study had Institutional Ethics Committee permission.

Results:
The study population included 428 subjects, (mean age 53.5 ± 14 years, female = 45%). Nine percent of the population had WC; 30% had MUCH which was driven by nocturnal hypertension with higher prevalence in patients with pre-hypertension; 24 hr, 68%; daytime, 56% and nighttime 86%(p < 0.0001). Overall, 71% of the patients had MUCH which was driven by nocturnal hypertension vs. 24-hr or daytime (70%. vs. 42% vs. 32%, P < 0.0001) respectively. Eighty percent of the cohort had non-dipping with similar prevalence in MUCH and uncontrolled hypertension. Compared with controlled BP, patients with MUCH had significantly higher ACR (18.8 ± 8 vs 6.2 ± 6, p < 0.01), PWV(11.2 vs. 9.9, p < 0.001) and hs-CRP (1.6 ± 1.4 vs. 6.4 ± 2.3, p < 0.01).

Conclusions:
This is the first study exploring ABPM phenotypes in a Saudi hypertensive population, showing a high prevalence of MUCH in apparently well-controlled patients, driven by nocturnal hypertension and associated with prehypertension. The MUCH population had greater TOD than those with controlled BP associated with a non-dipping pattern. Our results highlight the importance of ABPM in the management of hypertension in Saudi Arabia.
ENDOVASCULAR INTERVENTIONS FOR CHILDHOOD TAKAYASU ARTERITIS: A 16-YEAR REVIEW
Authors: Luyun Fan , Lirui Yang , Dongmei Wei , Wenjun Ma , Ying Lou , Lei Song , Jin Bian , Huimin Zhang , Jun Cai 
Published: April 2021

Objective:
Evidence-based studies on endovascular approaches for childhood Takayasu arteritis(c-TA) are limited. This study presented the real-world scenario of largest cohort up-to-date for c-TA patients undergoing interventions and their post-interventional outcomes.

Design and method:
Patients with c-TA satisfying the 1990 ACR or 2010 EULAR/PRINTO/PReS criteria were recruited from January 2002 to December 2017. Data on clinical, laboratory, imaging features, treatment and post-interventional outcomes were collected. Statistical analysis was performed based on data distribution. Complication-free survival and Re-intervention-free survival were projected by Kaplan-Meier methods and compared by Log-rank tests. Associated factors for intervention (or stenting) and predictors for post-interventional complications (or re-interventions) were assessed via Logistic regression and COX regression models, respectively.

Results:
Among 101 patients enrolled, 69(68.3%) underwent 121 interventions (Angioplasty 95; Stenting 26) during a median 3.1 years of follow-up. Compared with the medical treatment group, the intervention group appeared with fewer male population(18.8% vs 39.3%, OR = 0.2, p = 0.017) and more type IV disease(47.8% vs. 17.9%, OR = 10.60, p = 0.002). Male sex also indicated the risk for re-intervention(HR = 4.72, p = 0.016). Retinopathy(OR = 4.8, p = 0.027), time of delay in diagnosis per year(OR = 1.76, p = 0.016) and descending thoracic aorta involvement(OR = 10.19, p = 0.003) associated with stent insertion. Hypertension secondary to renal artery(59.4%) or mid-aorta(14.5%) stenosis, heart failure(21.7%), claudication(21.7%) served as leading clinical hints for interventions. Anti-inflammatory and anti-platelet therapies covered 89.9% and 91.3% patients, respectively. The technical success rate was 96.7%. Over median 2.88 years since intervention, 36 lesions occurred complications in 28 patients and 22 lesions in 17 patients, majorly on renal artery or mid-aorta. The 5-year complication-free and re-intervention survivals were 50.7% and 65.8%, separately. Dual antiplatelet therapy(HR = 0.28, p = 0.011), concurrent surgery(HR = 14.84, p = 0.002), retinopathy secondary to hypertension(HR = 3.54, p = 0.004), and pulmonary artery hypertension(HR = 3.0, p = 0.024) were independent predictors for complications.

Conclusions:
Over two-thirds c-TA patients require interventions and the 5-year complication-free survival is 50.7%. Male sex, retinopathy, and pulmonary artery hypertension alert unfavorable outcomes. Dual anti-platelet therapy appears to protect c-TA patients from post-interventional complications. Endovascular approaches can be a choice for mid-aorta and/or renal artery lesions caused by c-TA.