Unique ID issued by UMIN | UMIN000003870 |
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Receipt number | R000004657 |
Scientific Title | Intrarenal RAAS Activity can Modify Circadian Blood Pressure Rhythm in CKD |
Date of disclosure of the study information | 2010/07/08 |
Last modified on | 2012/09/30 22:02:32 |
Intrarenal RAAS Activity can Modify Circadian
Blood Pressure Rhythm in CKD
Intrarenal RAAS & Non-dipper
Intrarenal RAAS Activity can Modify Circadian
Blood Pressure Rhythm in CKD
Intrarenal RAAS & Non-dipper
Japan |
Chronic Kidney Disease (CKD)
Cardiology | Nephrology |
Others
NO
To address renal mechanism for non-dipper circadian rhythm of blood pressure (BP), we have postulated that both reduced glomerular ultrafiltration coefficient and enhanced tubular sodium reabsorption cause high sodium-sensitivity resulting in the defect in sodium excretory capacity. This in turn makes BP elevated during the night (non-dipper) in order to compensate for diminished natriuresis during daytime, thereby causing enhanced pressure natriuresis during the night. In fact, for patients with insulin resistance, diabetes mellitus, metabolic syndrome, and primary aldosteronism, non-dipper BP rhythm was noted despite preserved renal function. We also reported in patients with biopsy-proved glomerular diseases, as renal function deteriorated, nighttime BP was elevated. However, among these patients, some showed non-dipper BP rhythm even with preserved renal function. Consistent with this theory, we found that angiotensin receptor blocker could restore non-dipper circadian BP rhythm accompanied by increase in daytime natriuresis. We previously showed that the intrarenal activation of renin-angiotensin-aldosterone system (RAAS), which may stimulate tubular sodium reabsorption, could be caused by the augmentation of proximal tubular angiotensinogen (AGT) expression. Therefore, this study was performed to examine whether subjects with non-dipper BP rhythm showed increased AGT expression in renal proximal tubules in patients with CKD.
Others
Test the physiologic condition with no treatment.
Confirmatory
Pragmatic
Not applicable
Examine whether subjects with non-dipper rhythms of BP and natriuresis showed increased AGT expression in renal biopsy specimens (especially in proximal tubules) accompanied by enhanced tubular sodium reabsorption in patients with CKD.
24h BPs, glomerular filtration rate (GFR)
Observational
15 | years-old | <= |
Not applicable |
Male and Female
The subjects were patients with CKD, who underwent renal biopsy, 24h-ABPM, and urinary sampling for daytime and night-time under hospitalization at Nagoya City University Hospital.
1) Usage of antihypertensive agents, imcluding diuretics and RAAS inhibitors.
2) Increase in the dosages of steroids or immunosuppressor for 2 months before renal biopsy
3) Nephrotic syndrome with severe edema
40
1st name | |
Middle name | |
Last name | Michio Fukuda |
Nagoya City University
Cardio-Renal Medicine and Hypertension
1 Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
+81-52-853-8221
1st name | |
Middle name | |
Last name | Michio Fukuda |
Nagoya City University
Cardio-Renal Medicine and Hypertension
1 Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
+81-52-853-8221
m-fukuda@med.nagoya-cu.ac.jp
Nagoya City University Cardio-Renal Medicine and Hypertension
none
Self funding
Department of Physiology and Hypertension and Renal Center of Excellence, Tulane University Health Sciences Center
NO
名古屋市立大学病院(愛知県)
2010 | Year | 07 | Month | 08 | Day |
Published
Tubular sodium reabsorption is stimulated by intrarenal angiotensin II, as indicated by proximal tubular AGT, and contributes to the genesis of the non-dipper BP rhythm (J Hypertens 30:1453-1459, 2012).
Completed
2010 | Year | 01 | Month | 27 | Day |
2010 | Year | 02 | Month | 01 | Day |
2010 | Year | 07 | Month | 01 | Day |
2011 | Year | 06 | Month | 01 | Day |
2011 | Year | 07 | Month | 01 | Day |
2011 | Year | 07 | Month | 01 | Day |
Retrospective Cohort Study
2010 | Year | 07 | Month | 05 | Day |
2012 | Year | 09 | Month | 30 | Day |
Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000004657
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