Introduction
Materials and methods
About the CKD-JAC study
ABPM and patient questionnaire
Index calculated from ABPM
Hyperbaric area index is a novel indicator calculated from ABPM
Kidney function (eGFR and CKD stage)
Statistical analyses
Results
Background
Female | Male | |
---|---|---|
Number of participants | 393 (36.6) | 682 (63.4) |
Age (year) | 58.5 ± 12.3 | 62.0 ± 10.6 |
CKD stage | ||
3 | 169 (43.0) | 302 (44.3) |
4 | 165 (42.0) | 284 (41.6) |
5 | 59 (15.0) | 96 (14.1) |
eGFR (mL/min/1.73 m2) | 28.7 ± 12.6 | 28.8 ± 11.9 |
BMI (kg/m2) | 22.6 ± 4.3 | 23.6 ± 3.3 |
Overweight (BMI ≥25) | 78 (19.9) | 182 (26.7) |
Obesity (BMI ≥30) | 23 (5.85) | 29 (4.3) |
Antihypertensive medicine use | 343 (87.3) | 632 (92.7) |
Office SBP (mmHg) | 129.8 ± 18.6 | 132.1 ± 17.8 |
Office DBP (mmHg) | 76.3 ± 11.2 | 77.6 ± 11.5 |
Nocturnal BP change pattern | ||
Extreme dipper | 40 (10.2) | 65 (9.5) |
Dipper | 141 (35.9) | 254 (37.2) |
Non dipper | 148 (37.7) | 260 (38.1) |
Riser | 64 (16.3) | 103 (15.1) |
Morning BP surge (≥40 mmHg) | 55 (14.0) | 92 (13.5) |
Morning BP surge (mmHg) | 21.6 ± 16.6 | 23.5 ± 16.3 |
Diabetes mellitusa
| 128 (32.6) | 253 (37.1) |
Proteinuriab
| 345 (89.6) | 581 (88.0) |
Nocturia | 50 (12.8) | 154 (22.8) |
Much difficulty in sleep | 75 (19.1) | 143 (21.2) |
Examination period | ||
Summer | 102 (26.0) | 188 (27.6) |
Winter | 291 (74.1) | 494 (72.4) |
Patient questionnaires and NBPC patterns during ABPM implementation
HBI
N
| Female |
p value |
N
| Male |
p value | |
---|---|---|---|---|---|---|
393 | 176.5 ± 208.1 | 682 | 242.4 ± 252.5 | |||
Categorical variables | ||||||
Age | ||||||
20 | 7 | 133.5 ± 224.4 | 0.008 | 6 | 158.6 ± 102.1 | 0.09 |
30 | 36 | 110.7 ± 183.4 | 31 | 141.6 ± 177.9 | ||
40 | 46 | 145.8 ± 230.0 | 46 | 211.7 ± 225.1 | ||
50 | 90 | 140.6 ± 168.9 | 146 | 224.6 ± 234.2 | ||
60 | 130 | 193.8 ± 211.9 | 266 | 252.5 ± 265.0 | ||
70 | 84 | 236.7 ± 222.7 | 187 | 268.6 ± 264.2 | ||
CKD stage | ||||||
3 | 169 | 147.3 ± 181.9 | 0.03 | 302 | 196.7 ± 219.5 | <0.001 |
4 | 165 | 188.6 ± 222.1 | 284 | 261.7 ± 260.9 | ||
5 | 59 | 226.2 ± 228.0 | 96 | 328.8 ± 293.8 | ||
Overweight | ||||||
No | 315 | 161.1 ± 205.9 | 0.003 | 500 | 222.9 ± 238.1 | <0.001 |
Yes | 78 | 238.7 ± 206.5 | 182 | 295.8 ± 282.4 | ||
Obesity | ||||||
No | 370 | 168.2 ± 205.9 | 0.002 | 653 | 241.2 ± 253.8 | 0.59 |
Yes | 23 | 309.0 ± 201.9 | 29 | 267.3 ± 224.2 | ||
Antihypertensive medicine use | ||||||
No | 50 | 158.5 ± 207.2 | 0.51 | 50 | 146.7 ± 162.3 | 0.005 |
Yes | 343 | 179.1 ± 208.4 | 632 | 249.9 ± 256.9 | ||
Nocturnal BP change pattern | ||||||
Extreme dipper | 40 | 146.0 ± 169.0 | <0.001 | 65 | 180.5 ± 175.4 | <0.001 |
Dipper | 141 | 133.3 ± 157.5 | 254 | 197.0 ± 216.9 | ||
Non dipper | 148 | 172.1 ± 213.8 | 260 | 263.9 ± 254.8 | ||
Riser | 64 | 300.8 ± 263.2 | 103 | 338.7 ± 326.8 | ||
Morning BP surge | ||||||
No | 338 | 166.8 ± 205.3 | 0.02 | 590 | 235.2 ± 253.3 | 0.06 |
Yes | 55 | 236.1 ± 217.2 | 92 | 288.5 ± 244.0 | ||
Diabetes mellitus | ||||||
No | 265 | 139.0 ± 187.9 | <0.001 | 429 | 195.3 ± 213.6 | <0.001 |
Yes | 128 | 254.0 ± 226.6 | 253 | 322.2 ± 291.0 | ||
Proteinuria | ||||||
No | 40 | 66.5 ± 82.8 | <0.001 | 79 | 126.2 ± 149.0 | <0.001 |
Yes | 345 | 190.0 ± 215.7 | 581 | 258.4 ± 257.9 | ||
Nocturia | ||||||
No | 341 | 163.9 ± 200.9 | 0.003 | 523 | 224.7 ± 246.7 | <0.001 |
Yes | 50 | 257.9 ± 238.1 | 154 | 302.1 ± 264.1 | ||
Much difficulty in sleep | ||||||
No | 317 | 169.4 ± 199.8 | 0.15 | 532 | 239.0 ± 150.6 | 0.71 |
Yes | 75 | 208.3 ± 239.7 | 143 | 247.9 ± 255.1 | ||
Season | ||||||
Summer | 102 | 124.3 ± 160.0 | 0.003 | 188 | 201.8 ± 221.6 | 0.01 |
Winter | 291 | 194.8 ± 219.8 | 494 | 257.8 ± 261.9 | ||
Continuous variables | ||||||
Age (year) | 30.3 (13.6, 46.8) | <0.001 | 29.0 (11.1, 46.8) | 0.002 | ||
eGFR (10 mL/min/1.73 m2) | −26.0 (−42.2, −9.8) | 0.002 | −39.7 (−55.4, −24.0) | <0.001 | ||
SBP (10 mmHg) | 52.6 (42.8, 62.4) | <0.001 | 58.5 (48.9, 68.2) | <0.001 | ||
DBP (10 mmHg) | 45.8 (27.8, 63.7) | <0.001 | 39.2 (22.9, 55.6) | <0.001 | ||
24-h mean SBP (5 mmHg) | 58.5 (55.8, 61.2) | <0.001 | 67.9 (65.6, 70.1) | <0.001 | ||
24-h mean SBP (10 mmHg) | 117.0 (111.7, 122.4) | <0.001 | 135.7 (131.3, 140.1) | <0.001 | ||
BMI (1 kg/m2) | 11.2 (6.6, 15.8) | <0.001 | 9.0 (3.1, 14.9) | 0.003 | ||
Nocturnal BP change (10 %) | −60.9 (−83.1, −38.7) | <0.001 | −61.1 (−82.2, −40.0) | <0.001 | ||
Morning surge (10 mmHg) | 14.2 (1.7, 26.6) | 0.03 | 5.5 (−6.2, 17.1) | 0.36 |
Difference in systolic HBI (mmHg×h) |
p value | |
---|---|---|
Male(versus female) | 54.7 | <0.001 |
Age (10 years) | 2.4 | 0.70 |
eGFR (10 mL/min/1.73 m2) | −16.5 | 0.003 |
Proteinuria | 43.5 | 0.05 |
Diabetes mellitus | 72.6 | <0.001 |
BMI (kg/m2) | 5.8 | 0.001 |
SBP (10 mmHg) | 44.0 | <0.001 |
Nocturnal BP change (10 %) | −47.1 | <0.001 |
Nocturia | 46.4 | 0.007 |
Much difficulty in sleep | −5.8 | 0.71 |
Winter (versus Summer) | 51.6 | <0.001 |
Difference among office SBP, 24-h mean SBP, and HBI for detecting reduced kidney function
The relationship between HBI, NBPC, and eGFR
Female | DF | SS | MS |
F value |
p value |
---|---|---|---|---|---|
Model | 3 | 1872.7 | 624.2 | 4.03 | 0.008 |
Error | 389 | 60242.6 | 154.9 | ||
Corrected total | 392 | 62115.3 |
Female | DF | TypeII SS | MS |
F value |
p value |
---|---|---|---|---|---|
NBPC >10 %, <10 % | 1 | 365.8 | 365.8 | 2.36 | 0.13 |
BP load <75 percentile, >75 percentile | 1 | 1137.7 | 1137.7 | 7.35 | 0.007 |
Interaction term of NBPC and BP load | 1 | 33.1 | 33.1 | 0.21 | 0.64 |
Male | DF | SS | MS |
F value |
p value |
---|---|---|---|---|---|
Model | 3 | 3124.7 | 1041.6 | 7.57 | <0.001 |
Error | 678 | 93290.1 | 137.6 | ||
Corrected Total | 681 | 96414.8 |
Male | DF | TypeII SS | MS |
F value |
p value |
---|---|---|---|---|---|
NBPC >10 %, <10 % | 1 | 108.6 | 108.6 | 0.79 | 0.37 |
BP load <75 percentile, >75 percentile | 1 | 2798.8 | 2798.8 | 20.34 | <0.001 |
Interaction term of NBPC and | 1 | 42.5 | 42.5 | 0.31 | 0.58 |
Model A | Model B | |||
---|---|---|---|---|
Difference in eGFR (mL/min/1.73 m2) |
p value | Difference in eGFR (mL/min/1.73 m2) |
p value | |
Male (versus Female) | 1.29 | 0.09 | 1.23 | 0.11 |
Age (10 years) | −2.15 | <0.001 | −2.13 | <0.001 |
NBPC (10 %) | 0.48 | 0.08 | 0.47 | 0.27 |
Systolic HBI (100 mmHg×h) | −0.72 | <0.001 | −0.70 | <0.001 |
Much difficulty in sleep | −0.46 | 0.58 | ||
Winter (versus summer) | −0.73 | 0.41 |