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Duru, Obidiugwu Kenrik, MD; Li, Suying, PhD; Jurkovitz, Claudine, MD; Bakris, George, MD; Brown, Wendy, MD; Chen, Shu-Cheng, MS; Collins, Allan, MD; Klag, Michael, MD; McCullough, Peter A., MD; McGill, Janet, MD; Narva, Andrew, MD; Pergola, Pablo, MD, PhD; Singh, Ajay, MD; Norris, Keith, MD
American journal of kidney diseases, 02/2008, Letnik: 51, Številka: 2Journal Article
Background African American men with chronic kidney disease (CKD) progress to end-stage renal disease more rapidly than African American women or whites. Uncontrolled hypertension worsens CKD, and disparities in hypertension control may contribute to disparities in CKD progression. Study Design Cross-sectional. Setting & Participants 10,827 individuals with CKD and self-reported hypertension screened in the Kidney Early Evaluation Program. Predictors African American race, sex. Outcomes Hypertension control (blood pressure <130 mm Hg systolic and/or <80 mm Hg diastolic). Measurements Self-report, physical examination (blood pressure), laboratory data (serum creatinine, microalbuminuria by urine dipstick). We calculated estimated glomerular filtration rates by using the 4-variable isotope dilution mass spectrometry Modification of Diet in Renal Disease Study equation. We classified CKD as early (stages 1 to 2) or late (stages 3 to 5) based on estimated glomerular filtration rate and microalbuminuria. Results In individuals with early CKD, African American women (odds ratio OR, 1.47; 95% confidence interval CI, 1.14 to 1.88), white men (OR, 1.85; 95% CI, 1.39 to 2.46), and white women (OR, 1.69; 95% CI, 1.28 to 2.22) had greater odds of hypertension control (blood pressure <130/80 mm Hg) than African American men. In individuals with late CKD, white men (OR, 1.66; 95% CI, 1.10 to 2.52) and white women (OR, 1.67; 95% CI, 1.13 to 2.46) had greater odds of hypertension control than African American men. No differences were seen between African American men and women with late CKD. Limitations No information for medication regimens. Conclusions African American men with CKD have poorly controlled hypertension compared with African American women and whites, particularly in the early stages of disease. Efforts to aggressively treat hypertension in this population may help narrow the race and sex disparities in progression to end-stage renal disease.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Vir: Osebne bibliografije
in: SICRIS
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