Department of Translational Medical Sciences, University of Naples "Federico II", Napoli, Italy.
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Blood Press. 2024 Dec;33(1):2336243. doi: 10.1080/08037051.2024.2336243. Epub 2024 Apr 3.
Orthostatic hypotension (OH) may predispose older adults to health complications leading to functional impairment. Despite the central role of the kidney in blood pressure control, the contribution of renal function in orthostatic hypotension is poorly investigated. To verify the association between Chronic Kidney Disease (CKD) and OH a population of hospitalised elderly patients with comorbidities was studied.
174 patients were consecutively admitted to Acute Geriatric Wards. On admission, patients underwent postural systolic (SBP) and diastolic (DBP) blood pressure evaluation by automatic oscillometric device after 10 min rest in lying position, and in standing position at time 0, 1, 3 and 5 min. CKD was assumed for estimated glomerular filtration rate (e-GFR) less than 60 mL/min/1.73 m.
The mean age of the population enrolled was 74.4 ± 7.0. OH was found in 46.0% and CKD in 56.3% of patients, respectively. A lower e-GFR was observed in patients with (56.1 ± 16.7 mL/min/1.73 m) than in those without OH (61.1 ± 15.9 mL/min/1.73 m) ( < 0.05). A greater fall in SBP at 0-min (12.8 ± 6.3 vs. 7.7 ± 3.2 mmHg) and at 1-min (8.4 ± 4.5 vs. 5.7 ± 2.8 mmHg) was found in CKD patients in respect to patients without CKD during active standing test ( < 0.05). Similarly, a DBP reduction at 0-min and at 1-min was observed in CKD patients in respect to patients without CKD ( < 0.05). A multivariate logistic regression analysis showed that CKD was associated to OH (OR 2.426; 95%CI 1.192-4.937; = 0.014).
CKD is associated to OH in hospitalised older adults.
体位性低血压（OH）可能使老年人易患导致功能障碍的健康并发症。尽管肾脏在血压控制中起着核心作用，但肾脏功能在体位性低血压中的作用仍未得到充分研究。为了验证慢性肾脏病（CKD）与 OH 之间的关联，对患有合并症的住院老年患者进行了研究。
174 名患者连续入住急性老年病房。入院时，患者在卧位休息 10 分钟后，使用自动振荡装置测量体位收缩压（SBP）和舒张压（DBP），并在 0、1、3 和 5 分钟时测量站立位 SBP 和 DBP。假设估算肾小球滤过率（e-GFR）<60 mL/min/1.73 m 为 CKD。
纳入人群的平均年龄为 74.4±7.0。OH 发生率为 46.0%，CKD 发生率为 56.3%。与无 OH 患者（61.1±15.9 mL/min/1.73 m）相比，有 OH 患者的 e-GFR 较低（56.1±16.7 mL/min/1.73 m）（ < 0.05）。在主动站立试验中，CKD 患者在 0 分钟（12.8±6.3 与 7.7±3.2 mmHg）和 1 分钟（8.4±4.5 与 5.7±2.8 mmHg）时 SBP 下降更大（ < 0.05）。同样，CKD 患者在 0 分钟和 1 分钟时 DBP 下降也高于无 CKD 患者（ < 0.05）。多变量逻辑回归分析显示，CKD 与 OH 相关（OR 2.426；95%CI 1.192-4.937； = 0.014）。
CKD 与住院老年患者的 OH 相关。
