Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertension
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1080/07420528.2022.2088377 http://hdl.handle.net/11449/241278 |
Resumo: | In diabetes kidney disease (DKD), orthostatic hypotension and supine hypertension often coexist, which, when uncontrolled, contributes to the progression of proteinuria and renal dysfunction. Chronotherapy and elevation of the head of the bed during sleep are feasible clinical measures and could contribute to the control of supine hypertension and proteinuria in this group of patients. This study consists of a series of cases, in which nine consecutive patients with DKD, dysautonomia and supine hypertension (intervention group) were instructed to use chronotherapy and inclination of the head of the bed in six degrees during sleep. These patients were compared with a historical control group. The primary outcome was proteinuria behavior. The intervention group had a significant drop in proteinuria levels, while there was an increase in proteinuria in the control group (variation in the proteinuria/creatininuria index in an isolated sample from the intervention group: −6.60 ± 3.90 g/g; variation in the group control: +1.70 ± 7.10 g/g, p = 0.008). Chronotherapy and six-degree inclination of the head of the bed during sleep were associated with a significant decrease in proteinuria in patients in the intervention group, with conversion of nephrotic into non-nephrotic proteinuria in most of these patients. |
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Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertensionChronic kidney diseasechronotherapydiabetic nephropathyhypertensionproteinuriasupine hypertensionIn diabetes kidney disease (DKD), orthostatic hypotension and supine hypertension often coexist, which, when uncontrolled, contributes to the progression of proteinuria and renal dysfunction. Chronotherapy and elevation of the head of the bed during sleep are feasible clinical measures and could contribute to the control of supine hypertension and proteinuria in this group of patients. This study consists of a series of cases, in which nine consecutive patients with DKD, dysautonomia and supine hypertension (intervention group) were instructed to use chronotherapy and inclination of the head of the bed in six degrees during sleep. These patients were compared with a historical control group. The primary outcome was proteinuria behavior. The intervention group had a significant drop in proteinuria levels, while there was an increase in proteinuria in the control group (variation in the proteinuria/creatininuria index in an isolated sample from the intervention group: −6.60 ± 3.90 g/g; variation in the group control: +1.70 ± 7.10 g/g, p = 0.008). Chronotherapy and six-degree inclination of the head of the bed during sleep were associated with a significant decrease in proteinuria in patients in the intervention group, with conversion of nephrotic into non-nephrotic proteinuria in most of these patients.Department of Internal Medicine Botucatu Medical School São Paulo State University (Unesp)Department of Internal Medicine Botucatu Medical School São Paulo State University (Unesp)Universidade Estadual Paulista (UNESP)Palhares Aversa Santos, Guilherme [UNESP]Inomata Cardoso da Silva, Douglas [UNESP]Burgugi Banin, Vanessa [UNESP]Garcia Zanati Bazan, Silméia [UNESP]Barretti, Pasqual [UNESP]Jorge da Silva Franco, Roberto [UNESP]Martin, Luis Cuadrado [UNESP]2023-03-01T20:54:46Z2023-03-01T20:54:46Z2022-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1220-1225http://dx.doi.org/10.1080/07420528.2022.2088377Chronobiology International, v. 39, n. 9, p. 1220-1225, 2022.1525-60730742-0528http://hdl.handle.net/11449/24127810.1080/07420528.2022.20883772-s2.0-85133490867Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengChronobiology Internationalinfo:eu-repo/semantics/openAccess2023-03-01T20:54:47Zoai:repositorio.unesp.br:11449/241278Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462023-03-01T20:54:47Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertension |
title |
Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertension |
spellingShingle |
Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertension Palhares Aversa Santos, Guilherme [UNESP] Chronic kidney disease chronotherapy diabetic nephropathy hypertension proteinuria supine hypertension |
title_short |
Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertension |
title_full |
Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertension |
title_fullStr |
Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertension |
title_full_unstemmed |
Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertension |
title_sort |
Reduction of proteinuria in patients with diabetes kidney disease and dysautonomia through measures aimed at controlling supine hypertension |
author |
Palhares Aversa Santos, Guilherme [UNESP] |
author_facet |
Palhares Aversa Santos, Guilherme [UNESP] Inomata Cardoso da Silva, Douglas [UNESP] Burgugi Banin, Vanessa [UNESP] Garcia Zanati Bazan, Silméia [UNESP] Barretti, Pasqual [UNESP] Jorge da Silva Franco, Roberto [UNESP] Martin, Luis Cuadrado [UNESP] |
author_role |
author |
author2 |
Inomata Cardoso da Silva, Douglas [UNESP] Burgugi Banin, Vanessa [UNESP] Garcia Zanati Bazan, Silméia [UNESP] Barretti, Pasqual [UNESP] Jorge da Silva Franco, Roberto [UNESP] Martin, Luis Cuadrado [UNESP] |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (UNESP) |
dc.contributor.author.fl_str_mv |
Palhares Aversa Santos, Guilherme [UNESP] Inomata Cardoso da Silva, Douglas [UNESP] Burgugi Banin, Vanessa [UNESP] Garcia Zanati Bazan, Silméia [UNESP] Barretti, Pasqual [UNESP] Jorge da Silva Franco, Roberto [UNESP] Martin, Luis Cuadrado [UNESP] |
dc.subject.por.fl_str_mv |
Chronic kidney disease chronotherapy diabetic nephropathy hypertension proteinuria supine hypertension |
topic |
Chronic kidney disease chronotherapy diabetic nephropathy hypertension proteinuria supine hypertension |
description |
In diabetes kidney disease (DKD), orthostatic hypotension and supine hypertension often coexist, which, when uncontrolled, contributes to the progression of proteinuria and renal dysfunction. Chronotherapy and elevation of the head of the bed during sleep are feasible clinical measures and could contribute to the control of supine hypertension and proteinuria in this group of patients. This study consists of a series of cases, in which nine consecutive patients with DKD, dysautonomia and supine hypertension (intervention group) were instructed to use chronotherapy and inclination of the head of the bed in six degrees during sleep. These patients were compared with a historical control group. The primary outcome was proteinuria behavior. The intervention group had a significant drop in proteinuria levels, while there was an increase in proteinuria in the control group (variation in the proteinuria/creatininuria index in an isolated sample from the intervention group: −6.60 ± 3.90 g/g; variation in the group control: +1.70 ± 7.10 g/g, p = 0.008). Chronotherapy and six-degree inclination of the head of the bed during sleep were associated with a significant decrease in proteinuria in patients in the intervention group, with conversion of nephrotic into non-nephrotic proteinuria in most of these patients. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-01 2023-03-01T20:54:46Z 2023-03-01T20:54:46Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1080/07420528.2022.2088377 Chronobiology International, v. 39, n. 9, p. 1220-1225, 2022. 1525-6073 0742-0528 http://hdl.handle.net/11449/241278 10.1080/07420528.2022.2088377 2-s2.0-85133490867 |
url |
http://dx.doi.org/10.1080/07420528.2022.2088377 http://hdl.handle.net/11449/241278 |
identifier_str_mv |
Chronobiology International, v. 39, n. 9, p. 1220-1225, 2022. 1525-6073 0742-0528 10.1080/07420528.2022.2088377 2-s2.0-85133490867 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Chronobiology International |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
1220-1225 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1799964478029168640 |