| Japanese |
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| Title | 慢性腎臓病(Chronic Kidney Disease：CKD)における血清アルブミン値の血圧日内変動への影響 |
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| Subtitle | 原著 |
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| Authors | 安藤大作*, 安田元*, 小林麻裕美*, 金田朋子*, 吉田衝未*, 小林千夏*, 坂早苗*, 谷津圭介*, 平和伸仁*, 梅村敏** |
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| Authors(kana) | |
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| Organization | *横浜市立大学附属市民総合医療センター腎臓内科, **横浜市立大学附属病院病態制御内科学 |
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| Journal | 循環制御 |
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| Volume | 30 |
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| Number | 1 |
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| Page | 8-18 |
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| Year/Month | 2009/5 |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 『要旨』 背景：慢性腎臓病(Chronic Kidney Disease：CKD)では腎障害と血圧の夜間降圧障害の関連が報告されている. しかし, CKDにおける血清アルブミン値と血圧日内変動についての報告は少ないため, 今回検討した. 方法：進行した腎障害を認めず(血清クレアチニン値<1.5mg/dl), 尿蛋白排泄によって低アルブミン血症を合併したCKD患者を, 血清アルブミン値(S-Alb)<3.0g/dlのネフローゼ群と3.0<S-Alb<4.0g/dlの低アルブミン血症群に分けて, S-Alb>4.0g/dlのコントロール群と携帯型血圧計を用いて24時間血圧を比較検討した. 結果：3群間で24時間血圧には有意差を認めなかった. しかし, 平均血圧の睡眠時/覚醒時の比率は, コントロール群(0.85±0.07)<低アルブミン血症群(0.91±0.08)<ネフローゼ群(0.96±0.08)の順で有意に高値を示した(p<0.05 for respective two groups). 血清アルブミン値と平均血圧の睡眠時/覚醒時の比率は有意な負の相関関係を認めた(r=-0.58；p<0.001). 結論：CKD患者では, 腎機能障害が進行していない段階から血圧の夜間降圧障害を認め, その程度は血清アルブミン値に相関する. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | CKD, serum albumin level, circadian blood pressure rhythm, ABPM |
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| English |
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| Title | The Effect of Serum Albumin Levels on Circadian Rhythm of Blood Pressure in Patients with Chronic Kidney Disease |
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| Authors | Daisaku Andoh*, Gen Yasuda*, Mayumi Kobayashi*, Tomoko Kaneda*, Tugumi Yoshida*, Tinatu Kobayasi*, Sanae Saka*, Keisuke Yatsu*, Nobuhito Hirawa*, Satoshi Umemura** |
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| Authors(kana) | |
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| Organization | *Division of Nephrology, Yokohama City University School of Medicine, **Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 30 |
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| Number | 1 |
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| Page | 8-18 |
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| Year/Month | 2009/5 |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Background: In chronic kidney disease (CKD), renal dysfunction is associated with a loss of nocturnal blood pressure (BP) reduction. However, it remains unclear about the circadian rhythm of BP in CKD with hypoalbuminemia resulting from urinary protein excretion. We evaluated the relationship between the circadian BP rhythm and serum albumin level (S-Alb). Methods: Non-diabetic CKD patients without progressive renal dysfunction (serum creatinine level<1.5mg/dl) were divided into two groups, based on S-Alb: nephrotic syndrome (NS) group (less than 3.0g/dl; n=30) and Hypoalbuminemia group (3.0 to 4.0g/dl; n=32). Age and sex-matched normal subjects with normal albumin level (more than 4.0g/dl; n=32) were enrolled as Control group. Ambulatory 24-hour BP monitoring was conducted in all subjects. Results: There were no significant differences in 24-hour BP among three groups. However, sleeping/waking mean BP ratios were significantly increased gradually in the Control, Hypoalbuminemia and NS groups, in that order (0.85±0.07, 0.91±0.08, 0.96±0.08, respectively; p<0.05 for respective two groups). A significant reverse correlation was observed between S-Alb and sleeping/waking ratio of mean BP (r=-0.58; p<0.001). Conclusion: In non-diabetic CKD patients, loss of nocturnal BP reduction occurred even in the early stage, correlating with S-Alb. |
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| Practice | Basic medicine |
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| Keywords | CKD, serum albumin level, circadian blood pressure rhythm, ABPM |
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