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Halimi JM, Vernier LM, Gueguen J, Goin N, Gatault P, Sautenet B, Barbet C, Longuet H, Roumy J, Buchler M, Blacher J, de Freminville JB. End-diastolic velocity mediates the relationship between renal resistive index and the risk of death. J Hypertens 2023; 41:27-34. [PMID: 36129106 DOI: 10.1097/hjh.0000000000003293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Renal resistive index predicts the risk of death in many populations but the mechanism linking renal resistive index and death remains elusive. Renal resistive index is derived from end-diastolic velocity (EDV) and peak systolic velocity (PSV). However, the predictive value of EDV or PSV considered alone is unknown. METHODS We conducted a retrospective analysis of 2362 consecutive patients who received a kidney transplant from 1985 to 2017. EDV and PSV were measured at 3 months after transplantation, renal resistive index was calculated, and the risk of death was assessed [median follow-up: 6.25 years (0.25-29.15); total observation period: 13 201 patient-years]. RESULTS Doppler indices were available in 1721 of 2362 (78.9%) patients (exclusions: 113 who died or returned to dialysis before, 427 with no Doppler studies, 27 with renal artery stenosis, 74 missing values). Among them, 279 (16.4%) had diabetes before transplantation. Mean age was 51.5 ± 14.7, 1097 (63.7%) were male. During follow-up, 217 of 1721 (12.6%) patients died. Renal resistive index and EDV shared many determinants (notably systolic, diastolic and pulse pressure, recipient age and diabetes) unlike renal resistive index and PSV. EDV used as a binary [lowest tertile vs. higher values: (hazard ratio: 2.57 (1.96-3.36), P < 0.001)] and as a continuous (the lower EDV, the greater the risk of death) variable was significantly associated with the risk of death. This finding was confirmed in multivariable analyses. Prediction of similar magnitude was found for renal resistive index. No association was found between PSV used as a binary or a continuous variable and the risk of death. CONCLUSION Low EDV explains high renal resistive index, and the mechanism-linking renal resistive index to the risk of death is through low EDV.
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Affiliation(s)
- Jean-Michel Halimi
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
- EA4245, University of Tours, Tours
- INI-CRCT, Nancy
| | - Louis-Marie Vernier
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
| | - Juliette Gueguen
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
| | - Nicolas Goin
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
| | - Philippe Gatault
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
- EA4245, University of Tours, Tours
| | - Bénédicte Sautenet
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
- INI-CRCT, Nancy
- INSERM U1246 SPHERE, Université de Tours-Université de Nantes
| | - Christelle Barbet
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
| | - Hélène Longuet
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
| | - Jérôme Roumy
- Service d'Imagerie Médicale, Hôpital Bretonneau, CHU Tours, Tours
| | - Matthias Buchler
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
- EA4245, University of Tours, Tours
| | - Jacques Blacher
- Centre de Diagnostic et de Thérapeutique, Hôtel-Dieu
- Université Paris, Paris, France
| | - Jean-Baptiste de Freminville
- Service de Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours
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Jaques DA, Pruijm M, Ackermann D, Vogt B, Guessous I, Burnier M, Pechere-Bertschi A, Bochud M, Ponte B. Sodium Intake Is Associated With Renal Resistive Index in an Adult Population-Based Study. Hypertension 2020; 76:1898-1905. [PMID: 33012201 DOI: 10.1161/hypertensionaha.120.15932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Renal resistive index (RRI) has been associated with adverse renal and cardiovascular outcomes. Although traditionally considered a marker of intrinsic renal damage, RRI could also reflect systemic vascular dysfunction. As sodium intake was linked to alterations in vascular properties, we wished to characterize the association of salt consumption with RRI in the general adult population. Participants were recruited in a population-based study in Switzerland. RRI was measured by ultrasound in 3 segmental arteries. Sodium intake (UNa; mmol/24 h) was estimated on 24-hour urine samples. Carotido-femoral pulse wave velocity was obtained by applanation tonometry. Mixed multivariate regression models were used with RRI or pulse wave velocity as independent variables and UNa as dependent variable, adjusting for possible confounders. We included 1002 patients in the analyses with 528 (52.7%) women and mean age of 47.2±17.4. Mean values of UNa and RRI were 141.8±61.1 mmol/24 h and 63.8±5.5%, respectively. In multivariate analysis, UNa was positively associated with RRI (P=0.002) but not with pulse wave velocity (P=0.344). Plasma renin activity and aldosterone did not modify the relationship between UNa and RRI (P=0.087 for interaction). UNa/urinary potassium ratio was positively associated with pulse wave velocity ≥12 m/s (P=0.033). Our results suggest that dietary salt consumption has a direct impact on renal hemodynamic in the adult general population. Alterations in vascular properties likely explain those findings, but inadequate renal vaso-motor response is also possible. Sodium intake could thus potentially be linked to underlying structural systemic damages affecting this population.
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Affiliation(s)
- David A Jaques
- From the Division of Nephrology and Hypertension (D.A.J., A.P.-B., B.P.), Geneva University Hospitals, Switzerland
| | - Menno Pruijm
- Division of Nephrology and Hypertension, Lausanne University Hospitals, Switzerland (M.P., M.B.)
| | - Daniel Ackermann
- Division of Nephrology and Hypertension, Bern University Hospitals, Switzerland (D.A., B.V.)
| | - Bruno Vogt
- Division of Nephrology and Hypertension, Bern University Hospitals, Switzerland (D.A., B.V.)
| | - Idris Guessous
- Division of Primary Care Medicine (I.G.), Geneva University Hospitals, Switzerland
| | - Michel Burnier
- Division of Nephrology and Hypertension, Lausanne University Hospitals, Switzerland (M.P., M.B.).,University Centre for General Medicine and Public Health, Lausanne, Switzerland (M.B.)
| | - Antoinette Pechere-Bertschi
- From the Division of Nephrology and Hypertension (D.A.J., A.P.-B., B.P.), Geneva University Hospitals, Switzerland
| | | | - Belen Ponte
- From the Division of Nephrology and Hypertension (D.A.J., A.P.-B., B.P.), Geneva University Hospitals, Switzerland
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Roumeliotis S, Roumeliotis A, Stamou A, Leivaditis K, Kantartzi K, Panagoutsos S, Liakopoulos V. The Association of dp-ucMGP with Cardiovascular Morbidity and Decreased Renal Function in Diabetic Chronic Kidney Disease. Int J Mol Sci 2020; 21:E6035. [PMID: 32839405 PMCID: PMC7504709 DOI: 10.3390/ijms21176035] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022] Open
Abstract
We aimed to investigate the possible association of the inactive, dephosphorylated, uncarboxylated matrix Gla protein (dp-ucMGP) with oxidized low-density lipoprotein (ox-LDL) and all-cause/cardiovascular (CV) mortality and renal function in diabetic chronic kidney disease (CKD). Ox-LDL and dp-ucMGP were determined in 66 diabetic CKD patients. All patients were prospectively followed for seven years, or until the occurrence of death, or a composite renal outcome of 30% estimated glomerular filtration rate (eGFR) reduction or progression to end-stage renal disease (ESRD) requiring dialysis occurred. Secondary outcomes were the occurrence of CV events. Kaplan-Meier curves showed that patients with plasma dp-ucMGP levels above the median (≥656 pM) had a significantly higher risk for all study endpoints. After adjustment for several well-known cofounders, multivariate Cox analysis showed that high plasma dp-ucMGP levels were associated with all-cause mortality (Hazard ratio-HR = 2.63, 95% Confidence Interval-CI = 1.17-5.94, p = 0.02), CV mortality (HR = 2.82, 95% CI = 1.07-7.49, p = 0.037) and progression of CKD (HR = 4.02, 95% CI = 1.20-13.46, p = 0.024). Circulating dp-ucMGP is associated with mortality and decreased renal function in diabetic CKD.
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Affiliation(s)
- Stefanos Roumeliotis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (S.R.); (A.R.); (K.L.)
| | - Athanasios Roumeliotis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (S.R.); (A.R.); (K.L.)
| | - Aikaterini Stamou
- Department of Microbiology, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Konstantinos Leivaditis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (S.R.); (A.R.); (K.L.)
| | - Konstantia Kantartzi
- Department of Nephrology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (K.K.); (S.P.)
| | - Stylianos Panagoutsos
- Department of Nephrology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (K.K.); (S.P.)
| | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (S.R.); (A.R.); (K.L.)
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Ho HJ, Komai M, Shirakawa H. Beneficial Effects of Vitamin K Status on Glycemic Regulation and Diabetes Mellitus: A Mini-Review. Nutrients 2020; 12:nu12082485. [PMID: 32824773 PMCID: PMC7469006 DOI: 10.3390/nu12082485] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/16/2022] Open
Abstract
Type 2 diabetes mellitus is a chronic disease that is characterized by hyperglycemia, insulin resistance, and dysfunctional insulin secretion. Glycemic control remains a crucial contributor to the progression of type 2 diabetes mellitus as well as the prevention or delay in the onset of diabetes-related complications. Vitamin K is a fat-soluble vitamin that plays an important role in the regulation of the glycemic status. Supplementation of vitamin K may reduce the risk of diabetes mellitus and improve insulin sensitivity. This mini-review summarizes the recent insights into the beneficial effects of vitamin K and its possible mechanism of action on insulin sensitivity and glycemic status, thereby suppressing the progression of diabetes mellitus.
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Affiliation(s)
- Hsin-Jung Ho
- Laboratory of Nutrition, Graduate School of Agricultural Science, Tohoku University, Sendai 980-8572, Japan; (M.K.); (H.S.)
- Correspondence: ; Tel.: +81-11-706-3395
| | - Michio Komai
- Laboratory of Nutrition, Graduate School of Agricultural Science, Tohoku University, Sendai 980-8572, Japan; (M.K.); (H.S.)
| | - Hitoshi Shirakawa
- Laboratory of Nutrition, Graduate School of Agricultural Science, Tohoku University, Sendai 980-8572, Japan; (M.K.); (H.S.)
- International Education and Research Center for Food Agricultural Immunology, Graduate School of Agricultural Science, Tohoku University, Sendai 980-8572, Japan
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Jaques DA, Pivin E, Pruijm M, Ackermann D, Guessous I, Ehret G, Wei F, Staessen JA, Pechère‐Bertschi A, Vermeer C, Vogt B, Burnier M, Martin P, Bochud M, Ponte B. Renal Resistive Index Is Associated With Inactive Matrix Gla (γ-Carboxyglutamate) Protein in an Adult Population-Based Study. J Am Heart Assoc 2019; 8:e013558. [PMID: 31510823 PMCID: PMC6818003 DOI: 10.1161/jaha.119.013558] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 08/09/2019] [Indexed: 02/06/2023]
Abstract
Background Increased renal resistive index (RRI) has been associated with target organ damage as well as renal and cardiovascular outcomes. Matrix Gla (γ-carboxyglutamate) protein (MGP) is a strong inhibitor of soft tissue calcification. Its inactive form (dephospho-uncarboxylated MGP [dp-ucMGP]) has been associated with vascular stiffness, cardiovascular outcomes, and mortality. In this study, we hypothesized that high levels of dp-ucMGP were associated with increased RRI. Methods and Results We recruited participants via a multicenter family-based cross-sectional study in Switzerland. Levels of dp-ucMGP were measured in plasma by sandwich ELISA. RRI was measured by Doppler ultrasound in 3 segmental arteries in both kidneys. We used mixed regression models to assess the relationship between dp-ucMGP and RRI. We adjusted for common determinants of RRI as well as renal function and cardiovascular risk factors. We included 1006 participants in our analyses: 526 women and 480 men. Mean values were 0.44±0.20 nmol/L for dp-ucMGP and 64±5% for RRI. After multivariable adjustment, dp-ucMGP was positively associated with RRI (P=0.001). In subgroup analysis by age tertiles, this association was not significant in the youngest age group (<38 years; P=0.62), whereas it was significant in older age groups (38-55 and >55 years; P=0.016 and P<0.001, respectively). Conclusions Levels of dp-ucMGP are positively and independently associated with RRI after adjustment for common determinants of RRI, cardiovascular risk factors, and renal function. The stronger association among older adults is probably due, in part, to age-related arterial stiffness. RRI thus seems to reflect the global atherosclerotic burden in a general adult population.
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Affiliation(s)
- David A. Jaques
- Division of NephrologyGeneva University HospitalsGenevaSwitzerland
| | - Edward Pivin
- Division of Chronic DiseaseUniversity Institute of Social and Preventive MedicineLausanne University HospitalLausanneSwitzerland
| | - Menno Pruijm
- Division of Nephrology and HypertensionLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Daniel Ackermann
- University Clinic for Nephrology, Hypertension and Clinical PharmacologyBern University HospitalBernSwitzerland
| | - Idris Guessous
- Division of Primary Care MedicineDepartment of Primary Care MedicineGeneva University HospitalsGenevaSwitzerland
| | - Georg Ehret
- Division of CardiologyGeneva University HospitalsGenevaSwitzerland
| | - Fang‐Fei Wei
- Studies Coordinating CentreResearch Unit of Hypertension and Cardiovascular EpidemiologyKU Leuven Department of Cardiovascular SciencesUniversity of LeuvenBelgium
| | - Jan A. Staessen
- Studies Coordinating CentreResearch Unit of Hypertension and Cardiovascular EpidemiologyKU Leuven Department of Cardiovascular SciencesUniversity of LeuvenBelgium
| | | | - Cees Vermeer
- R&D Group VitaKMaastricht UniversityMaastrichtThe Netherlands
| | - Bruno Vogt
- University Clinic for Nephrology, Hypertension and Clinical PharmacologyBern University HospitalBernSwitzerland
| | - Michel Burnier
- Division of Nephrology and HypertensionLausanne University Hospital and University of LausanneLausanneSwitzerland
| | | | - Murielle Bochud
- Division of Chronic DiseaseUniversity Institute of Social and Preventive MedicineLausanne University HospitalLausanneSwitzerland
| | - Belen Ponte
- Division of NephrologyGeneva University HospitalsGenevaSwitzerland
- Division of Chronic DiseaseUniversity Institute of Social and Preventive MedicineLausanne University HospitalLausanneSwitzerland
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