Factors affecting renal function in 119 985 adults over three years.

Blood pressure, proteinuria and serum creatinine (SCr) were examined in 119 985 adults, aged 40 years and older, who attended annual health examinations both in 1993 and 3 years later. Renal function was assessed from SCr; changes in individuals' renal function were estimated using the slope of the regression line for the reciprocal of the SCr level vs. time (slope of rSCr) over the 3-year period. Age-dependent SCr concentration increments were observed; however, there was no significant age-dependent change in the slope of rSCr. SCr in hypertensives on anti-hypertensive medication was significantly higher than that in untreated hypertensives, borderline hypertensives and normotensives. The slopes of rSCr in hypertensives (treated, untreated and borderline) were steeper than normotensives in males, and that in untreated hypertensives was steeper than other groups in females. In hypertensives with proteinuria, SCr was higher and renal function deteriorated more rapidly, compared with hypertensives without proteinuria. Hypertension with proteinuria appears to be an important indicator for progressive decline in renal function, this trend being more obvious in males. Renal function decreases with age; however, the rate of decline is constant. The influences of proteinuria and blood pressure on renal function are different in males and females.

[1]  T. Hosoya,et al.  Changes in renal function with aging among Japanese. , 1995, Internal medicine.

[2]  H. Parving,et al.  EARLY AGGRESSIVE ANTIHYPERTENSIVE TREATMENT REDUCES RATE OF DECLINE IN KIDNEY FUNCTION IN DIABETIC NEPHROPATHY , 1983, The Lancet.

[3]  T. Greene,et al.  Blood Pressure Control, Proteinuria, and the Progression of Renal Disease , 1995, Annals of Internal Medicine.

[4]  P. Zucchelli,et al.  Comparison of losartan and amlodipine in renally impaired hypertensive patients. , 1998, Kidney international. Supplement.

[5]  M. Hartford,et al.  Effect of 14 years of antihypertensive treatment on renal function and urinary albumin excretion in primary hypertension. , 1996, American journal of hypertension.

[6]  K. Kudo Renal function during antihypertensive treatment , 1995, The Lancet.

[7]  M Ishii,et al.  [The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, and 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension]. , 2000, Nihon rinsho. Japanese journal of clinical medicine.

[8]  S. Rosansky,et al.  The association of blood pressure levels and change in renal function in hypertensive and nonhypertensive subjects. , 1990, Archives of internal medicine.

[9]  A. Gruskin,et al.  Laboratory evaluation of renal function. , 1976, Pediatric clinics of North America.

[10]  Douglas A. Wolfe,et al.  Nonparametric Statistical Methods , 1973 .

[11]  R. Toto,et al.  "Strict" blood pressure control and progression of renal disease in hypertensive nephrosclerosis. , 1995, Kidney international.

[12]  W. Stead,et al.  Progression of renal insufficiency: role of blood pressure. , 1989, Kidney international.

[13]  George W. Williams,et al.  The modification of diet in renal disease study group , 1991 .

[14]  J. Cutler,et al.  Renal function change in hypertensive members of the Multiple Risk Factor Intervention Trial. Racial and treatment effects. The MRFIT Research Group. , 1992 .

[15]  P. Ellis,et al.  Renal impairment in elderly patients with hypertension and diabetes. , 2001, QJM : monthly journal of the Association of Physicians.

[16]  K. Yamagata,et al.  A long-term follow-up study of asymptomatic hematuria and/or proteinuria in adults. , 1996, Clinical nephrology.

[17]  H. Dustan,et al.  Renal insufficiency in treated essential hypertension. , 1989, The New England journal of medicine.

[18]  C. Mogensen Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy , 1982, British medical journal.

[19]  A. H. Norris,et al.  The effect of age on creatinine clearance in men: a cross-sectional and longitudinal study. , 1976, Journal of gerontology.

[20]  F. Locatelli,et al.  Effect of the Angiotensin-Converting–Enzyme Inhibitor Benazepril on the Progression of Chronic Renal Insufficiency , 1996 .

[21]  M. Blaufox,et al.  Prognostic value of serum creatinine and effect of treatment of hypertension on renal function. Results from the hypertension detection and follow-up program. The Hypertension Detection and Follow-up Program Cooperative Group. , 1989, Hypertension.

[22]  L. Dworkin,et al.  Does essential hypertension cause end-stage renal disease? , 1992, Kidney international. Supplement.

[23]  L. Ruilope,et al.  120 Does an adequate control of blood pressure protect the kidney in essential hypertension? , 1988, Journal of hypertension.

[24]  N W Shock,et al.  Longitudinal Studies on the Rate of Decline in Renal Function with Age , 1985, Journal of the American Geriatrics Society.

[25]  J. Bergström,et al.  Progression of chronic renal failure in man is retarded with more frequent clinical follow-ups and better blood pressure control. , 1986, Clinical nephrology.

[26]  M. Blaufox,et al.  Prognostic Value of Serum Creatinine and Effect of Treatment of Hypertension on Renal Function: Results From the Hypertension Detection and Follow‐up Program , 1989 .

[27]  XII. International comparisons of ESRD therapy. , 1999, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[28]  L. Welt,et al.  Diseases of the Kidney , 1905, The Hospital.

[29]  K. Iseki,et al.  Risk of developing end-stage renal disease in a cohort of mass screening. , 1996, Kidney international.

[30]  C. Borror Nonparametric Statistical Methods, 2nd, Ed. , 2001 .

[31]  D. Wolfe,et al.  Nonparametric Statistical Methods. , 1974 .

[32]  N. Shock,et al.  Association between blood pressure and the rate of decline in renal function with age. , 1984, Kidney international.

[33]  P. Whelton,et al.  Blood pressure and end-stage renal disease in men. , 1996, The New England journal of medicine.

[34]  P. Whelton,et al.  A Prospective Study of Blood Pressure and Serum Creatinine: Results From the 'Clue' Study and the ARIC Study , 1993 .

[35]  F. Locatelli,et al.  Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The Angiotensin-Converting-Enzyme Inhibition in Progressive Renal Insufficiency Study Group. , 1996, The New England journal of medicine.

[36]  D. Fliser,et al.  Renal function in the elderly: impact of hypertension and cardiac function. , 1997, Kidney international.

[37]  K. Iseki,et al.  Risk factors of end-stage renal disease and serum creatinine in a community-based mass screening. , 1997, Kidney international.