Blood Pressure Abnormalities Associated with Gut Microbiota-Derived Short Chain Fatty Acids in Children with Congenital Anomalies of the Kidney and Urinary Tract
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Biochemical Analysis
2.3. Office Blood Pressure and 24 h Ambulatory Blood Pressure Monitoring (ABPM)
2.4. Gas Chromatography-Flame Ionization Detector (GC-FID)
2.5. Analysis of Gut Microbiota Composition
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Group | CAKUT | Non-CAKUT | ||
---|---|---|---|---|
N = 57 | N = 21 | |||
Children | Adolescents | Children | Adolescents | |
N = 39 | N = 18 | N = 6 | N = 15 | |
Gender: M:F | 24:15 | 11:7 | 5:1 | 9:6 |
CKD staging | ||||
Stage G1 | 33 | 6 | 5 | 7 |
Stage G2 | 3 | 9 | 0 | 5 |
Stage G3 | 3 | 2 | 1 | 3 |
Stage G4 | 0 | 1 | 0 | 0 |
Age, years | 7.5 (5.5–10.3) | 15.8 (14.1–17.5) a | 10.2 (7.9–11.4) | 15.7 (13.9–16.9) a |
Body height, percentile | 50 (15–75) | 50 (25–77.5) | 25 (3–58.8) | 25 (3–50) |
Body weight, percentile | 25 (15–75) | 50 (12–85) | 25 (3–85) | 25 (15–85) |
Systolic blood pressure, mmHg | 105 (101–113) | 121 (111–130) a | 114 (105–119) | 124 (112–136) |
Diastolic blood pressure, mmHg | 69 (64–73) | 74 (71–82) a | 75 (63–82) | 70 (64–78) |
Body mass index, kg·m−2 | 15.6 (14.7–17.7) | 20.8 (17.8–24.8) a | 18.3 (13.9–23.2) | 20.3 (18.3–23.6) |
Hypertension (by office BP) | 12 (30%) | 6 (33%) | 5 (83%) b | 6 (40%) |
Blood urea nitrogen, mg/dL | 13 (10–16) | 13 (12–15) | 14 (11–20) | 12 (11–15) |
Creatinine, mg/dL | 0.5 (0.42–0.56) | 0.86 (0.64–0.97) a | 0.37 (0.19–0.75) | 0.73 (0.58–1) a |
eGFR, mL/min/1.73 m2 | 104 (96–116) | 82 (71–101) a | 136 (103–393) b | 88 (71–113) a |
CKD progression | 2 (5.1%) | 7 (38.9%) a | 1 (16.7%) | 5 (33.3%) |
Urine total protein-to-creatinine ratio, mg/g | 49 (34–72) | 71 (29–172) | 2364 (709–12,293) b | 273 (51–1282) |
Hemoglobin, g/dL | 13.4 (12.8–14) | 14.2 (12.2–16.2) | 13.4 (12.7–14.5) | 12.9 (11.9–14.2) |
Hematocrit, % | 39.4 (37.9–41.3) | 42.2 (37.1–46.1) | 38.8 (37.2–40.3) | 38.1 (36–41.6) |
Total cholesterol, mg/dL | 174 (155–194) | 146 (130–166) a | 239 (158–353) | 185 (132–207) |
LDL, mg/dL | 89 (74–110) | 80 (59–99) | 140 (92–252) b | 96 (69–129) |
Triglyceride, mg/dL | 61 (43–87) | 65 (51–106) | 98 (91–159) b | 66 (45–156) |
Uric acid, mg/dL | 4.8 (3.9–5.4) | 5.9 (5.5–6.8) a | 7.6 (4.1–8.7) | 6.9 (5.2–9) |
Sodium, mEq/L | 141 (139–142) | 142 (140–143) | 141 (137–142) | 140 (140–142) |
Potassium, mEq/L | 4.4 (4.3–4.7) | 4.4 (4.2–4.6) | 4.2 (3.6–4.9) | 4.4 (4–4.7) |
Calcium, mg/dL | 9.9 (9.7–10.1) | 9.9 (9.5–10.2) | 8.5 (7.3–9.8) b | 9.6 (9.2–9.6) |
Phosphate, mg/dL | 5 (4.7–5.3) | 4.5 (4.1–4.9) a | 4.5 (4.1–4.7) b | 4.3 (3.9–4.4) |
Group | CAKUT | Non-CAKUT |
---|---|---|
24 h ABPM | N = 37 | N = 18 |
Abnormal ABPM profile (with any of the following abnormalities) | 24 (65%) | 14 (78%) |
Average 24 h BP >95th percentile | 7 (19%) | 7 (39%) |
Average daytime BP >95th percentile | 8 (22%) | 8 (44%) |
Average nighttime >95th percentile | 7 (19%) | 8 (44%) * |
BP load ≥25% | 16 (43%) | 14 (78%) * |
Nocturnal decrease of BP <10% | 20 (54%) | 9 (50%) |
Arterial stiffness assessment | ||
AASI | 0.35 (0.22–0.46) | 0.38 (0.25–0.49) |
Plasma Level | CAKUT | Non-CAKUT |
---|---|---|
Acetate, μM | 56.4 (48.5–68.1) | 57.9 (46–83.4) |
Propionate, μM | 1.8 (1.5–2.2) | 2.5 (1.6–3.3) * |
Butyrate, μM | 1.4 (1.1–1.7) | 1.8 (1.2–2.2) |
BP | n | Acetate | Propionate | Butyrate |
---|---|---|---|---|
24 h BP | ||||
Abnormal | 14 | 65.7 (49.4–73.5) | 2.4 (1.6–3.4) * | 1.9 (1.2–2.6) * |
Normal | 40 | 56.1 (46–66.6) | 1.9 (1.5–2.2) | 1.5 (1.1–1.6) |
Daytime BP | ||||
Abnormal | 16 | 65.7 (47.3–77.2) | 2.4 (1.6–3.3) * | 1.8 (1.2–2.4) * |
Normal | 38 | 56.1 (45.5–65.7) | 1.9 (1.5–2.2) | 1.4 (1.1–1.6) |
Nighttime BP | ||||
Abnormal | 15 | 68.1 (50.5–79.1) | 2.5 (1.6–3.5) * | 1.9 (1.2–2.5) * |
Normal | 39 | 55.8 (45.9–65.3) | 1.8 (1.5–2.2) | 1.4 (1.1–1.6) |
BP load | ||||
Abnormal | 30 | 59.5 (46.1–73.5) | 2.2 (1.6–2.8) * | 1.4 (1.1–1.9) |
Normal | 24 | 52.5 (46.2–65.2) | 1.8 (1.4–2.1) | 1.5 (1.2–1.6) |
Night dipping | ||||
Abnormal | 29 | 58.9 (48–75.3) | 2 (1.6–2.6) | 1.3 (0.8–1.7) |
Normal | 25 | 55.8 (44.5–66.2) | 1.8 (1.5–2.4) | 1.5 (1.3–1.9) |
ABPM profile | ||||
Abnormal | 38 | 59 (46.4–68.6) | 2 (1.7–2.7) | 1.4 (1–1.8) |
Normal | 16 | 54.2 (42.7–64.5) | 1.8 (1.3–2.2) | 1.5 (1.3–1.8) |
Office BP | ||||
Abnormal | 29 | 54.3 (49.4–68.6) | 2 (1.7–2.7) | 1.5 (1.2–1.9) |
Normal | 47 | 56.9 (46.5–71.5) | 1.8 (1.5–2.2) | 1.4 (1–1.7) |
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Hsu, C.-N.; Lu, P.-C.; Hou, C.-Y.; Tain, Y.-L. Blood Pressure Abnormalities Associated with Gut Microbiota-Derived Short Chain Fatty Acids in Children with Congenital Anomalies of the Kidney and Urinary Tract. J. Clin. Med. 2019, 8, 1090. https://doi.org/10.3390/jcm8081090
Hsu C-N, Lu P-C, Hou C-Y, Tain Y-L. Blood Pressure Abnormalities Associated with Gut Microbiota-Derived Short Chain Fatty Acids in Children with Congenital Anomalies of the Kidney and Urinary Tract. Journal of Clinical Medicine. 2019; 8(8):1090. https://doi.org/10.3390/jcm8081090
Chicago/Turabian StyleHsu, Chien-Ning, Pei-Chen Lu, Chih-Yao Hou, and You-Lin Tain. 2019. "Blood Pressure Abnormalities Associated with Gut Microbiota-Derived Short Chain Fatty Acids in Children with Congenital Anomalies of the Kidney and Urinary Tract" Journal of Clinical Medicine 8, no. 8: 1090. https://doi.org/10.3390/jcm8081090