Basic survey for hypertension & dyslipidemia in CKD patients Internal Medicine Jang Hye Ryoun.

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Presentation transcript:

Basic survey for hypertension & dyslipidemia in CKD patients Internal Medicine Jang Hye Ryoun

CKD & cardiovascular risk CKD - independent risk factor of CVD Non-traditional risk factors - type of CKD- calcium and phosphorus - degree of ↓GFR- oxidative stress - proteinuria- uremic toxins - inflammation- renin-angiotensin - malnutrition - anemia

Purpose Collection of baseline data for treatment of hypertension and dyslipidemia in non-DM CKD patients Inclusion criteria - CKD stage 2~4 - non-diabetic renal disease - age; 18~70 - follow-up period; more than 3 years

CKD stage Staging of CKD (chronic kidney disease) stage 1 ; GFR ≥ 90 mL/min/1.73m 2 stage 2 ; GFR 60~89 mL/min/1.73m 2 stage 3 ; GFR 30~59 mL/min/1.73m 2 stage 4 ; GFR 15~29 mL/min/1.73m 2 stage 5 ; GFR < 15 mL/min/1.73m 2 → CKD stage 2~4 included Staging according to the modified MDRD equation ; 186 x (Scr [mg/dL]) x (age [year]) x (0.742 if female)

Exclusion criteria Age; 70 years DM Liver cirrhosis Hepatorenal syndrome Pregnant patients

Transporter homology

NHE3, SGLT 1 & 2, NPT type II Proximal tubule TRPV5, calbindin-D 28K NCCT Distal tubule NKCC2 Loop of Henle

NHE3 Homo sapiens solute carrier family 9 (sodium/hydrogen exchanger), member 3 (SLC9A3), mRNA Length=2584 Score = 4783 bits (2413), Expect = 0.0 Identities = 2413/2413 (100%), Gaps = 0/2413 (0%) Rattus norvegicus solute carrier family 9 (sodium/hydrogen exchanger), member 3 (Slc9a3), mRNA Length=5153 Score = 1935 bits (976), Expect = 0.0 Identities = 2042/2396 (85%), Gaps = 6/2396 (0%) Mus musculus Na+/H+ exchanger (NHE-3) mRNA, partial cds Length=274 Score = 167 bits (84), Expect = 2e-37 Identities = 215/258 (83%), Gaps = 3/258 (1%) Rabbit ?

SGLT 1 Homo sapiens solute carrier family 5 (sodium/glucose cotransporter), member 1 (SLC5A1), mRNA Length=2449 Score = 4795 bits (2419), Expect = 0.0 Identities = 2449/2449 (100%), Gaps = 0/2449 (0%) Rattus norvegicus solute carrier family 5 (sodium/glucose cotransporter), member 1 (Slc5a1), mRNA Length=2627 Score = 1479 bits (746), Expect = 0.0 Identities = 1442/1674 (86%), Gaps = 0/1674 (0%) Mus musculus solute carrier family 5 (sodium/glucose cotransporter), member 1 (Slc5a1), mRNA Length=3917 Score = 1067 bits (538), Expect = 0.0 Identities = 1083/1264 (85%), Gaps = 3/1264 (0%) Pig Na+/glucose cotransporter protein (SGLT1) mRNA, 3' end Length=3649 Score = 1810 bits (913), Expect = 0.0 Identities = 1596/1824 (87%), Gaps = 6/1824 (0%)

SGLT 2 Homo sapiens solute carrier family 5 (sodium/glucose cotransporter), member 2 (SLC5A2), mRNA Length=2273 Score = 4506 bits (2273), Expect = 0.0 Identities = 2273/2273 (100%), Gaps = 0/2273 (0%) Rattus norvegicus solute carrier family 5 (sodium/glucose cotransporter), member 2 (Slc5a2), mRNA Length=2254 Score = 1528 bits (771), Expect = 0.0 Identities = 1457/1683 (86%), Gaps = 2/1683 (0%) Mus musculus low affinity sodium-dependent glucose cotransporter (Sglt2) mRNA Length=2035 Score = 1465 bits (739), Expect = 0.0 Identities = 1452/1687 (86%), Gaps = 2/1687 (0%) Sus scrofa sodium/glucose cotransporter (SGLT1) mRNA Length=2013 Score = 178 bits (90), Expect = 5e-41 Identities = 177/206 (85%), Gaps = 0/206 (0%)

NPT type II Homo sapiens solute carrier family 34 (sodium phosphate), member 2 (SLC34A2), mRNA Length=2280 Score = 3761 bits (1897), Expect = 0.0 Identities = 1897/1897 (100%), Gaps = 0/1897 (0%) Rattus norvegicus solute carrier family 34 (sodium phosphate), member 2 (Slc34a2), mRNA Length=3950 Score = 626 bits (316), Expect = 7e-176 Identities = 733/872 (84%), Gaps = 0/872 (0%) Mus musculus solute carrier family 34 (sodium phosphate), member 2 (Slc34a2), mRNA Length=4159 Score = 587 bits (296), Expect = 6e-164 Identities = 620/728 (85%), Gaps = 0/728 (0%) Bos taurus (cattle) solute carrier family 34 (sodium phosphate), member 2 (SLC34A2), mRNA Length=2266 Score = 1158 bits (584), Expect = 0.0 Identities = 1277/1508 (84%), Gaps = 0/1508 (0%)

NKCC2 Homo sapiens solute carrier family 12 (sodium/potassium/chloride transporters), member 1 (SLC12A1), mRNA Length=3362 Score = 6581 bits (3320), Expect = 0.0 Identities = 3362/3362 (100%), Gaps = 0/3362 (0%) Rattus norvegicus solute carrier family 12, member 1 (Slc12a1), mRNA Length=4595 Score = 3154 bits (1591), Expect = 0.0 Identities = 2792/3181 (87%), Gaps = 0/3181 (0%) Mus musculus solute carrier family 12, member 1 (Slc12a1), transcript variant 2, mRNA Length=4655 Score = 3362 bits (1696), Expect = 0.0 Identities = 2822/3182 (88%), Gaps = 2/3182 (0%)

TRPV5 Homo sapiens transient receptor potential cation channel, subfamily V, member 5 (TRPV5), mRNA Length=2486 Score = 4698 bits (2370), Expect = 0.0 Identities = 2370/2370 (100%), Gaps = 0/2370 (0%) Rattus norvegicus transient receptor potential cation channel, subfamily V, member 5 (Trpv5), mRNA Length=4860 Score = 484 bits (244), Expect = 7e-133 Identities = 714/870 (82%), Gaps = 3/870 (0%) Mus musculus transient receptor potential cation channel, subfamily V, member 5 (Trpv5), mRNA Length=2172 Score = 1150 bits (580), Expect = 0.0 Identities = 1521/1834 (82%), Gaps = 3/1834 (0%)

Calbindin-D 28K Homo sapiens calbindin 1, 28kDa (CALB1), mRNA Length=2531 Score = 4595 bits (2318), Expect = 0.0 Identities = 2360/2360 (100%), Gaps = 0/2360 (0%) Rattus norvegicus calbindin 1 (Calb1), mRNA Length=2280 Score = 1362 bits (687), Expect = 0.0 Identities = 943/1027 (91%), Gaps = 1/1027 (0%) Mus musculus calbindin-28K (Calb1), mRNA Length=2808 Score = 1378 bits (695), Expect = 0.0 Identities = 951/1035 (91%), Gaps = 1/1035 (0%) Gallus gallus (chicken) calbindin 1, 28kDa (CALB1), mRNA Length=2790 Score = 198 bits (100), Expect = 7e-47 Identities = 276/332 (83%), Gaps = 2/332 (0%)

NCCT Homo sapiens solute carrier family 12 (sodium/chloride transporters), member 3 (SLC12A3), mRNA Length=3131 Score = 6207 bits (3131), Expect = 0.0 Identities = 3131/3131 (100%), Gaps = 0/3131 (0%) Rattus norvegicus solute carrier family 12, member 3 (Slc12a3), mRNA Length=4361 Score = 2286 bits (1153), Expect = 0.0 Identities = 2013/2299 (87%), Gaps = 3/2299 (0%) Mus musculus solute carrier family 12, member 3 (Slc12a3), mRNA Length=3020 Score = 2226 bits (1123), Expect = 0.0 Identities = 2006/2299 (87%), Gaps = 6/2299 (0%) Zebrafish ?

Summary IdentitiesRattus norvegicusMus musculus NHE385%83% SGLT186%85% SGLT286% NPT type II84%85% NKCC287%88% NCCT87% TRPV582% Calbindin-D 28K 91%