bluuebunny/crossref_metadata_2025_split huggingface dataset:
PHENOTYPIC CHARACTERISTICS OF PATIENTS WITH INCREASED ARTERIAL STIFFNESS IN A HYPERTENSION UNIT
Authors: Camafort Miguel , Suarez Ana , Benitez Cristina , Fernández Carolina , Aldea Anna , Coloma Emmanuel , Torresa Manuel , Mayor Miriam , Viñas Esther , Guio Ana , Sepulveda Constanza , Coca Antonio 
Published: May 2024

Objective:
Arterial stiffness is related to the increase in morbidity and mortality of patients with arterial hypertension (HTN). The characteristics of a sample of patients where PWV was performed.
Our goal was to look for differential characteristics among those with increased PVW.

Design and method:
Retrospective study of patients assessed in the hypertension unit of a tertiary hospital during 2019.
Patients were assessed through ABPM by Space labs(R), Ankle brachial index by ABI Huntleigh (R) and PWV measured by Sphygmocor®.
Characteristics of patients with High PWV are presented.

Results:
A total of 22 patients were included, mean age was 60 (± 18.1), average abdominal circumference was 99.3 cm (± 18) and average BMI was 28.55 kg/m2 (± 6.4). Office Blood pressure (BP): Mean systolic BP of 156mmHg (± 22), a mean diastolic BP of 76.58mmHg (± 10.89), a mean heart rate (HR) of 69bpm (± 10), mean central systolic BP of 135.66mmHg (± 10.76) and mean central diastolic BP of 81mmHg (± 12.4).
An ankle-brachial index (ABI) was performed on 9 patients, with a mean right ABI of 120 (± 11.87) with a mean intima media thickness (IMG) of 626 (± 206.1) and a mean left ABI of 118 (± 14.61) with an IMT of 631.7 (± 143.83).
Ambulatory blood pressure monitoring (ABPM) was performed in 11 of the patients, which showed a mean systolic BP of 138mmHg (± 17.57), mean diastolic BP of 75mmHg (± 11.65), and mean HR of 68bpm (± 11.94).
Regarding the correlation with the laboratory findings, a mean glucose value of 108 g/dL (± 29.9), mean triglycerides of 146.9mg/dL (± 54), mean cholesterol of 191.27mg/dL (± 40.94), mean LDL of 114mg/dL (± 36.57) and mean HDL of 48.7mg/dL (± 11.37), and a mean glomerular filtration rate of 64ml/min (± 14.25).
This sample was compared with patients with non-pathological PWV, with no significant differences between the groups.

Conclusions:
We did not find statistically significant associations, in our data, that would allow us to differentiate patients who had pathological OPV during the first visit. More studies are needed
EFFECT OF ALPHA GALACTOSIDASE ON ARTERIAL HYPERTENSION AND ITS COMPLICATIONS IN PATIENTS WITH FABRY DISEASE
Authors: Cherif Abdelghani Bachir , Bennouar Salam , Bellahmer Sihem 
Published: May 2024

Objective:
Fabry disease (FD) is an X-linked lysosomal storage disease caused by alpha-galactosidase A deficiency. It leads to multi-systemic damage from a very young age. The diagnosis is mainly clinical and confirmed by the measurement of enzymatic activity. The objective of our study is to evaluated the blood pressure profile as well as the effect of enzymotherapy on the control of hypertension.

Design and method:
We studied 9 Fabry patients (5 male and 4 female) over a period of 1 years regarding disease progression and clinical outcome under enzyme replacement therapy. All Fabry cases benefited from a complete physical examination and additional tests to assess multi-system involvement. The diagnosis is mainly clinical and confirmed by the measurement of enzymatic activity. All patients received alpha galactosidase.

Results:
At baseline, 9 patients demonstrated at least 6 fibrotic left ventricular segments, 3 had 1 left ventricular segment affected (mild fibrosis). In patients without fibrosis, enzyme replacement therapy resulted in a significant reduction in left ventricular mass (232 ± 33 g at baseline, 215 ±26 g at 1 years; P <0.001). The prevalence of hypertension was 66%, whereas hypertension in patients with chronic kidney disease ranged 81%. A study using 24-hour ambulatory blood pressure monitoring (ABPM) to measure blood pressure (BP) indicated a high prevalence of uncontrolled hypertension in FD. Enzyme replacement therapy with recombinant alpha-galactosidase A reduces blood pressure and left ventricular hypertrophy in all patients. We found larger treatment effects in patients with baseline estimated glomerular filtration rates greater than 56 mL/min per 1.73 m2 (hazard ratio, 0.15 [CI, 0.03 to 0.71]; P 0.01) compared with 50 mL/min per 1.73 m2 or less (hazard ratio, 0.75 [CI, 0.28 to 2.1]; P 0.8) (formal test for interaction, P 0.07). Most treatment-related adverse events were mild or moderate infusion-associated reactions, reported by 55% of patients in the agalsidase-A group.

Conclusions:
Fabry disease is a rare and potentially serious disease because of its renal and cardiac complications. Early diagnosis is fundamental. Modern management of patients with FD must combine treatment of hypertension and enzyme therapy as early as possible.
NOCTURNAL HYPERTENSION: THE VEILED DARK SIDE OF HYPERTENSION MANAGEMENT IN A REAL WORLD
Authors: Liu Jing , Liu Jiahui ,   Nhig
Published: May 2024

Objective:
Nocturnal hypertension (NH) is highly prevalent among Chinese and Asian populations, while it is usually undetected and uncontrolled in real world clinical practice. This study is aimed to explore the status of nocturnal blood pressure (BP) control in subjects undergone 24h ambulatory blood pressure monitoring (ABPM) in China.

Design and method:
A nationwide 24h ABPM database was analyzed. NH was defined as average nighttime BP >=120/70 mmHg according to the recent Chinese and European hypertension guidelines.

Results:
A total of 210782 Chinese adult subjects undergone 24h ABPM between 2020-2022 with suspected and established hypertension were include in this preliminary analysis. Half of the participants was male, the mean age was 59.5(+/-15.3) years. The average nocturnal BP was 127.8/76.0 (+/- 20.0/ 12.9) mmHg. Overall, nocturnal BP was under controlled (<120/70 mmHg) among 23% of the participants, 20% in male, 26% in female, much less than the 45% of daytime BP control and 35% of 24h average BP control in the total subjects. Nighttime systolic BP <120 mmHg was found in 37% of the participants, while nighttime diastolic BP<70 mmHg was seen in 32% of the participants.

Conclusions:
NH was uncontrolled in about 3/4 of Chinese adults undergone 24h ABPM, indicating an urgent need for NH detecting and managing in practice.
THE ASSOCIATION BETWEEN HYPERTENSION SUBTYPES DEFINED BY HOME BLOOD PRESSURE IN HYPERTENSIVE PATIENTS AND INCIDENCE OF HYPERTENSION MEDIATED ORGAN DAMAGE
Authors: Phanmaneelux Nutthaphol , Buranakitjaroen Peera , Kunanon Sirisawat , Roubsanthisuk Weranuj , Chotruangnapa Chavalit 
Published: May 2024

Objective:
To investigate the association between different hypertension subtypes, based on home blood pressure measurements, and new-onset hypertension mediated organ damage (HMOD).

Design and method:
A retrospective cohort study was conducted from January 2019 to March 2023. Patients, who aged at least 18 years and did not have HMOD, were categorized into normotension, isolated diastolic hypertension (IDH), isolated systolic hypertension (ISH), and combined systolic-diastolic hypertension (SDH) based on the average 7-consecutive-day home blood pressure. The primary outcome was a composite of the first following events of HMOD, including ischemic heart disease, heart failure, stroke, chronic kidney disease, new-onset proteinuria, and death. The secondary outcomes consisted of each HMOD and change of estimated glomerular filtration rate (eGFR).

Results:
The total of 2,351 patients were screened and the 1,314 patients were finally enrolled. The median follow-up period was 24.10 ± 12.54 months. Most of them were women (65.91%) and did not have diabetes mellitus (81.66%). The overall baseline eGFR was 87.75 ± 15.57 ml/min/1.73m2. The average home systolic and diastolic blood pressure were 121.76 ± 7.49/ 73.37 ± 7.10 mmHg in normotensive group, 127.84 ± 5.02/ 88.20 ± 3.48 mmHg in IDH group, 140.60 ± 6.14/ 74.79 ± 7.17 mmHg in ISH group, and 143.45 ± 9.09/ 91.74 ± 5.67 mmHg in SDH group. Multivariable Cox proportional analysis demonstrated that patients with IDH, ISH, and SDH had a similar risk of the composite primary outcome compared to normotensive individuals (adjusted HR of 1.12, 95% CI (0.52 to 2.45), p-value = 0.770 in IDH; adjusted HR of 1.25, 95% CI (0.74 to 2.10), p-value = 0.406 in ISH; adjusted HR of 0.81, 95% CI (0.34 to 1.91), p-value = 0.633 in SDH). However, ISH was significantly associated with an increased risk of slope of eGFR decline (mean change was -2.48 ml/min/1.73m2/year, 95% CI (-3.71 to -1.25), p-value < 0.001). No significant associations were observed for the other secondary endpoints.

Conclusions:
Although hypertension subtypes defined by home blood pressure might not increase the incidence of composite HMOD, patients with ISH had significantly higher rate of annual renal function loss.
VACUOLAR H+-ATPASE AND MEGALIN-MEDIATED PRORENIN UPTAKE: FOCUS ON ELEMENTS BEYOND THE (PRO)RENIN RECEPTOR
Authors: Wang Na , Lu Xifeng , Danser A.H. Jan 
Published: May 2024

Objective:
Megalin is a multiple-ligand receptor that contributes to the reabsorption of filtered proteins (including albumin) in the kidney. Recently, megalin was found to act as a novel endocytic receptor for renin and prorenin. This internalization process depended on the (pro)renin receptor [(P)RR]. The (P)RR is an accessory protein of vacuolar H+-ATPase (V-ATPase), a structurally conserved multi-subunit complex, consisting of 14 subunits and two accessory proteins. Here we explored whether V-ATPase elements other than the (P)RR also affect megalin-mediated (pro)renin uptake.

Design and method:
Using RNAi technology, we inhibited each individual V-ATPase subunit in megalin-expressing BN16 cells. Subsequently, we quantified megalin expression and the uptake of prorenin and bovine serum albumin. Moreover, to unravel the underlying molecular mechanisms, we investigated adaptor proteins autosomal recessive hypercholesterolemia (ARH) and disabled-2 (Dab2), which are important for the endocytosis of megalin, and glycogen synthase kinase-3 beta (GSK-3 beta), a regulatory factor of megalin cell surface expression and recycling.

Results:
Silencing the subunit Atp6voa1 reduced prorenin and albumin uptake by 18.6 and 8.9%, while silencing the subunit Atp6ap1 increased prorenin and albumin uptake by 14.5 and 4.4%. Silencing the other subunits did not result in significantly altered prorenin uptake. Silencing Atp6voa1 reduced surface megalin density, without altering its mRNA and total protein levels, and this was associated with increased phosphorylation of GSK-3 beta. Silencing Atp6ap1 increased megalin mRNA and total protein expression and this was accompanied by ARH upregulation, while Dab2 expression was unaltered.

Conclusions:
V-ATPase units differently affect megalin-mediated reabsorption of prorenin, thereby offering novel pharmacological targets to not only affect renal renin-angiotensin system activity, but also to treat renal diseases that are associated with disturbed protein reabsorption, like Dent's disease.
48-HOUR AMBULATORY BLOOD PRESSURE MEASUREMENT AND VOLUME STATUS IN CHRONIC HEMODIALYSIS PATIENTS
Authors: Varda Luka , Piko Nejc , Petreski Tadej , Bevc Sebastjan , Hojs Radovan , Ekart Robert 
Published: May 2024

Objective:
Both arterial hypertension and fluid overload present prevalent risk factors for cardiovascular morbidity and mortality in end-stage kidney disease patients. Bioelectrical impedance analysis (BIA) is a promising method to assess hypervolemia in hemodialysis (HD) patients. A consensus on how to correctly assess blood pressure (BP) values in HD patients remains to be reached. Ambulatory BP measurement (ABPM) has been found to closely correlate with end-organ damage and cardiovascular risk. Less is known about the significance of 48-hour ABPM and its correlation with overhydration in HD patients.

Design and method:
88 randomly selected chronic HD patients completed a 48-hour ABPM and BIA using a body composition monitor before the midweek HD session. Statistical analysis was performed using commercially available SPSS® (version 29.0; Chicago, IL, USA). Descriptive statistics and Pearson's parametric correlation test were performed. P-values of less than 0.05 were considered statistically significant.

Results:
Included patients were male in 61.4%, with a mean age of 63.7±13.1 years and median dialysis vintage of 47 (95% CI (48.4, 75.6)) months. 21 (23.9%) patients had a dipping pattern, 62 (70.5%) were overhydrated for more than 1 L, and 50% of those patients for more than 2.5 L. Patients’ antihypertensive therapy and their 48-hour ABPM are presented in Tables 1 and 2, respectively. We found a statistically significant and positive correlation between the average 48-hour systolic BP, day-time systolic BP, night-time diastolic BP and overhydration assessed by BIA (r=0.217; p=0.044; r=0.225, p=0.036; r=0.224, p=0.038, respectively) (Table 2).

Conclusions:
Increased average 48-hour systolic BP, day-time systolic BP and night-time diastolic BP directly correlate with overhydration measured by BIA in chronic HD patients.
SODIUM-MEDIATED BLOOD PRESSURE RISE IS ASSOCIATED WITH A LOWER VASODILATION RESPONSE TO NITROGLYCERIN IN HEALTHY CONTROLS, BUT NOT IN PATIENTS WITH CKD
Authors: Duin Robert Van , Oppelaar Jetta J. , Van Den Born Bert -Jan , Engberink Rik H. Olde , Vogt Liffert 
Published: May 2024

Objective:
Chronic kidney disease (CKD) is characterized by endothelial dysfunction, that is partly caused by reduced bioavailability of NO. In addition to volume overload, endothelial dysfunction may contribute to hypertension in CKD. High sodium consumption affects NO levels, potentially leading to impaired vasorelaxation and a salt-sensitive blood pressure (BP) response. Whether salt-sensitivity in CKD is related to impaired NO bioavailability remains unknown. In this randomized-crossover-study, the vasoresponse to the NO donor nitroglycerin (NTG) during a high sodium diet in both CKD and healthy controls (HC) was assessed.

Design and method:
CKD patients (KDIGO stage G2-3A, proteinuria >0.5 g/d) and HC followed a 7-day low sodium control diet (LSD, <50mmol/d) and high sodium diet (HSD, >200mmol/d) in random order. After each diet, the hemodynamic profile was assessed by daytime BP and cardiac output (CO) measurements, by which systemic vascular resistance (SVR) was calculated. Nitroglycerin was administered to assess SVR changes.

Results:
We included 15 CKD patients (mean age, 49 yrs; median (IQR) proteinuria 0.7 (0.6-1.4) g/d; and plasma creatinine 129 (105-160) μmol/l) and 16 HC (41 yrs). Dietary salt intervention was comparable in the CKD and HC groups. After HSD, mean (SD) systolic BP increased in CKD by 9.7 mmHg (9.8; p<0.01) as compared to 3.1 mmHg ((6.0), p=0.07)) in HC (between-group difference p=0.04). After HSD, changes in body weight and CO did not differ between groups. Median (IQR) SVR change after HSD was 163.0 (-34.9-275.7) in CKD and -13.8 ((-299.4–61.4),p=0.03) dyn/sec/cm-5 in HC. In HC, salt-mediated blood pressure change was positively associated with a NTG-induced SVR change during HSD (r= 0.70, p= 0.01). This association was not present in CKD (r=-0.24, p=0.34) and significantly different from that in HC (p<0.01).

Conclusions:
CKD patients have a higher sodium-mediated BP response with comparable change of fluid status but a different SVR change as compared to HC. In HC, impaired sensitivity to the NO donor nitroglycerin associates with higher BP response to sodium. No such association was found in CKD patients, suggesting that persistent endothelial dysfunction is pivotal for salt sensitivity in CKD.
BLOOD PRESSURE CONTROL IN HEMODIALYSIS PATIENTS: CONTRIBUTION OF BIO -IMPEDANCEMETRY
Authors: Riguen Mouna , Fendri Beya , Kmicha Erij Ben , Abid Hanen , Dammak Najla , Agrebi Ikram , Chaker Hanen , Yaich Soumaya , Kammoun Khawla , Toumi Salma , Hmida Mohamed Ben 
Published: May 2024

Objective:
Arterial hypertension is common in hemodialysis patients of which physiopathology is multifactorial. Moreover, it is associated with an increased risk of cardiovascular disease and a higher mortality. Fluid overload is the main contributing factor. Few studies have assessed the interpretation of parameters obtained through bioelectrical impedance (BIA) for the management of these patients.

Design and method:
we conducted a cross-sectional study at the Hemodialysis Center of Hedi Chaker in Sfax, Tunisia. Multifrequency bioimpedance analysis (BIA) was used to assess the hydration status which is performed at the end of the dialysis session.

Results:
Our study included 29 patients, with a mean age of 46.8 years (21-78 years) and an average dialysis vintage of 92.4 months. Male predominance was noted with a sex ratio of 1.06. Forty-eight percent of patients were hypertensive. Twenty-three percent of patients were on triple antihypertensive therapy, 13.3% were on dual therapy, and 16.7% were on monotherapy. Hypertension was essential in 64.2% of cases, renin-dependent in 14.2%, and volume-dependent in 21.6% of cases. Twenty-point seven percent (20.7%) of patients were in fluid overload, with an average overhydration of 0.9 liters. The impedance measurements were consistent with the data from cardiac ultrasound. The diameter of the inferior vena cava was significantly correlated with overload (p=0.01). However, there is no correlation between pulmonary arterial hypertension (HTAP) and the hyperhydration (p=0.4).

Conclusions:
Bio-impedancemetry is a valuable and simple tool at the patient's bedside for the dry weight estimation and the proper management of volume status in chronic hemodialysis patients, and consequently, blood pressure control.
FINERENONE TREATMENT PREVENTS GLOMERULAR DAMAGE AND RENAL INTERSTITIAL INFLAMMATION IN TYPE 1 DIABETIC RATS WITH CHRONIC KIDNEY DISEASE
Authors: Mateos Esther Durán , Palma-guzmán Paloma , Mercado-garcía Elisa , Ruíz-hurtado Gema , Kolkhof Peter , Plaza Adrián , Kreutz Reinhold , Fernández-alfonso Maria S. 
Published: May 2024

Objective:
Finerenone (FIN), a non-steroidal mineralocorticoid receptor antagonist, has shown a protective effect on kidney and cardiovascular damage progression in type 1 diabetic Munich Wistar Frömter rats with established chronic kidney disease (CKD). The gradual decline in kidney function in diabetic CKD is due to a thickening of glomerular and Bowman capsule basement membranes, mesangial matrix expansion, and tubulointerstitial fibrosis. In this study we aimed to characterize whether the renal protection of FIN is related to a decrease in kidney damage through histomorphological changes in diabetic MWF rats.

Design and method:
Diabetes was induced by a streptozotocin injection (15 mg/Kg, i.p.) together with exposure to a high fat/high sucrose (HF/HS) diet (MWF-D) for 6 weeks. The MWF-D-FIN group was additionally treated with 10 mg/Kg/day of FIN included in the HF/HS diet (n = 6/group). Morphometrical analysis of renal structural changes was performed under hematoxylin and eosin staining, and light microscopy. Matrix metalloproteinases (MMP)-2 and MMP-9 activities were determined by zymography.

Results:
MWF-D and MWF-D-EP rats exhibited significantly elevated glycemia, water intake, urine volume, glucosuria, and kidney weight compared to control MWF. Histological examination of kidney samples of MWF and MWF-D rats showed hypertrophic glomeruli with an increase of the glomerular tuft and the Bowman's space. These pathological alterations were prevented by FIN treatment. The percentage of glomerulosclerosis was significantly higher in MWF and MWF-D rats and 59% lower in the MWF-D-FIN group (p<0.001) whereas the glomerulosclerosis index was reduced to 33% by FIN (p<0.001). Moreover, MWF-D rats showed an increased interstitial inflammation index compared to MWF rats (p<0.001) which was reduced to 44% (p<0.001) in the MWF-D-FIN group. Since an increase in MMP-2 and MMP-9 activities are associated with fibrosis development, these were determined by zymography in kidney samples of all groups. Both MMP-2 and MMP-9 were significantly higher in MWF-D compared to MWF and decreased by FIN treatment.

Conclusions:
In conclusion FIN prevents the development of diabetic kidney damage due to a reduction in glomerular alterations and interstitial inflammation associated to an inhibition of MMP-2 and MMP-9 activities.
THRESHOLDS AND PREVALENCE OF GLOMERULAR HYPERFILTRATION ACROSS BLOOD PRESSURE CATEGORIES IN LOW-RISK EUROPEAN POPULATION
Authors: Jelakovic Ana , Domislovic Marija , Kos Jelena , Josipovic Josipa , Gellineo Lana , Fucek Mirjana , Pecin Ivan , Bilajac Lovorka , Jelakovic Bojan 
Published: May 2024

Objective:
Aims of this study were to define thresholds for GH in a healthy low-risk European population using an age and gender-specific 95th percentile cut-offs, and to determine the prevalence of GH based on various eGFR equations across blood pressure (BP) categories.

Design and method:
In cross-sectional survey we included 1105 apparently healthy untreated participants from general population. There were 294, 412, and 400 normotensive, prehypertensive, and untreated hypertensive participants, respectively. The eGFR was calculated using CKD Epi equations, absolute GFR equation, MDRD and Cockcroft-Gault equations. Subjects were divided into the age quintiles. Prevalence of GF was determined for each equation and differences among BP categories were calculated.

Results:
Highest prevalence was found when GFR was estimated with CKD EPI equations. The lowest prevalence was observed with absolute GFR and Cockcroft-Gault equations (Figure 1). We failed to find differences in the prevalence of GH among the BP categories with the CKD EPI equations. Significant positive trend in the prevalence of GH from subjects with normal BP to the subjects with untreated hypertension was found when we used absolute GFR and Cockcroft-Gault equations. Subjects with GH had more obesity, dyslipidaemia, inflammation and salt intake compared to subjects with normal eGFR. In multinominal logistic regression, among subjects with eGFR >60 ml/min/1.73 m2, PP > 60 mmHg, ACR and salt intake increases the risk for GH by 96.4%, 90% and 83.9%, respectively. In the group of subjects with eGFR < 60 ml/min/1.73 m2, PP > 60 mmHg, ACR and being obese vs. having normal BMI increases the risk for GH by 94.4%, 88.8% and 10.2%, respectively. Obesity, ACR, PP and salt intake are risk factors for GH in apparently healthy Caucasians.

Conclusions:
There is no unique threshold value for GH, and age-gender - 95th cut off values should be used. CKD-Epi equations overestimate the prevalence of GH compared to de-indexed and Cockcroft-Gault equations. Differences in GH prevalence among BP categories were observed only without indexation for 1.73.