Clinical Implications of the Change in Glomerular Filtration Rate with Adrenergic Blockers in Patients with Morning Hypertension: The Japan Morning Surge-1 Study

Background. The aim of this study was to clarify the relationship between the change in estimated glomerular filtration rate (eGFR) and urinary albumin by antihypertensive treatment. Methods. We randomized 611 treated patients with morning hypertension into either an added treatment group, for whom...

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Main Authors: Seiichi Shibasaki, Kazuo Eguchi, Yoshio Matsui, Kazuyuki Shimada, Kazuomi Kario
Format: Article
Language:English
Published: Hindawi Limited 2013-01-01
Series:International Journal of Hypertension
Online Access:http://dx.doi.org/10.1155/2013/413469
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spelling doaj-f9ae1760bd664d619e38c645eafc19712020-11-25T00:51:45ZengHindawi LimitedInternational Journal of Hypertension2090-03842090-03922013-01-01201310.1155/2013/413469413469Clinical Implications of the Change in Glomerular Filtration Rate with Adrenergic Blockers in Patients with Morning Hypertension: The Japan Morning Surge-1 StudySeiichi Shibasaki0Kazuo Eguchi1Yoshio Matsui2Kazuyuki Shimada3Kazuomi Kario4Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, JapanDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, JapanDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, JapanDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, JapanDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, JapanBackground. The aim of this study was to clarify the relationship between the change in estimated glomerular filtration rate (eGFR) and urinary albumin by antihypertensive treatment. Methods. We randomized 611 treated patients with morning hypertension into either an added treatment group, for whom doxazosin was added to the current medication, or a control group, who continued their current medications. We compared the change in eGFR and urinary albumin creatinine ratio (UACR) between the groups. Results. The extent of the reduction in eGFR was significantly greater in the added treatment group than in the control group (−3.83  versus −1.08 mL/min/1.73 m2, P=0.001). In multivariable analyses, the change in eGFR was positively associated with the change in UACR in the added treatment group (β=0.20, P=0.001), but not in the control group (β=−0.002, P=0.97). When the changes in eGFR were divided by each CKD stage, eGFR was significantly more decreased in stage 1 than in the other stages in the added treatment group (P<0.001), but no differences were seen in the control group (P=0.44). Conclusion. The reduction of eGFR could be seen only in the early stage of CKD, and this treatment appeared to have no negative effect on renal function.http://dx.doi.org/10.1155/2013/413469
collection DOAJ
language English
format Article
sources DOAJ
author Seiichi Shibasaki
Kazuo Eguchi
Yoshio Matsui
Kazuyuki Shimada
Kazuomi Kario
spellingShingle Seiichi Shibasaki
Kazuo Eguchi
Yoshio Matsui
Kazuyuki Shimada
Kazuomi Kario
Clinical Implications of the Change in Glomerular Filtration Rate with Adrenergic Blockers in Patients with Morning Hypertension: The Japan Morning Surge-1 Study
International Journal of Hypertension
author_facet Seiichi Shibasaki
Kazuo Eguchi
Yoshio Matsui
Kazuyuki Shimada
Kazuomi Kario
author_sort Seiichi Shibasaki
title Clinical Implications of the Change in Glomerular Filtration Rate with Adrenergic Blockers in Patients with Morning Hypertension: The Japan Morning Surge-1 Study
title_short Clinical Implications of the Change in Glomerular Filtration Rate with Adrenergic Blockers in Patients with Morning Hypertension: The Japan Morning Surge-1 Study
title_full Clinical Implications of the Change in Glomerular Filtration Rate with Adrenergic Blockers in Patients with Morning Hypertension: The Japan Morning Surge-1 Study
title_fullStr Clinical Implications of the Change in Glomerular Filtration Rate with Adrenergic Blockers in Patients with Morning Hypertension: The Japan Morning Surge-1 Study
title_full_unstemmed Clinical Implications of the Change in Glomerular Filtration Rate with Adrenergic Blockers in Patients with Morning Hypertension: The Japan Morning Surge-1 Study
title_sort clinical implications of the change in glomerular filtration rate with adrenergic blockers in patients with morning hypertension: the japan morning surge-1 study
publisher Hindawi Limited
series International Journal of Hypertension
issn 2090-0384
2090-0392
publishDate 2013-01-01
description Background. The aim of this study was to clarify the relationship between the change in estimated glomerular filtration rate (eGFR) and urinary albumin by antihypertensive treatment. Methods. We randomized 611 treated patients with morning hypertension into either an added treatment group, for whom doxazosin was added to the current medication, or a control group, who continued their current medications. We compared the change in eGFR and urinary albumin creatinine ratio (UACR) between the groups. Results. The extent of the reduction in eGFR was significantly greater in the added treatment group than in the control group (−3.83  versus −1.08 mL/min/1.73 m2, P=0.001). In multivariable analyses, the change in eGFR was positively associated with the change in UACR in the added treatment group (β=0.20, P=0.001), but not in the control group (β=−0.002, P=0.97). When the changes in eGFR were divided by each CKD stage, eGFR was significantly more decreased in stage 1 than in the other stages in the added treatment group (P<0.001), but no differences were seen in the control group (P=0.44). Conclusion. The reduction of eGFR could be seen only in the early stage of CKD, and this treatment appeared to have no negative effect on renal function.
url http://dx.doi.org/10.1155/2013/413469
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