Accepted for/Published in: JMIR Research Protocols
Date Submitted: May 26, 2019
Open Peer Review Period: May 31, 2019 - Jun 14, 2019
Date Accepted: Aug 7, 2019
(closed for review but you can still tweet)
Association between Selected Molecular BiOmarkers and AmbuLatory Blood Pressure Pattern in African Chronic Kidney Disease and Hypertensive Patients compared with normotensIve Controls: The SyMBOLIC Study Protocol
ABSTRACT
Background:
Chronic kidney disease (CKD) is a burgeoning epidemic in Sub-Saharan. Abnormal blood pressure variations are prevalent in CKD and potentiate the risk of cardiovascular morbidity and mortality. Certain genetic variants [Angiotensin II Receptor (AGTR1 1166 A>C) and ACE I/D polymorphisms] and biomarkers such as interleukin (IL)-6, tumor necrosis factor (TNF), soluble (s) E-selectin, homocysteine and highly sensitive C-reactive protein (hs-CRP) have been shown to affect blood pressure variability among non-African CKD, hypertensive and non-hypertensive CKD population. However, the contributions of the pattern, genetic, and environmental determinants of ambulatory blood pressure in African CKD have not been characterized. Understanding these interactions may help to develop interventions to prevent major cardiovascular events among people with CKD.
Objective:
The overarching objective this study is to identify, document, and develop approaches to address related phenomics, genetic, and environmental determinants of ambulatory blood pressure pattern in African CKD and non-CKD hypertensive patients compared with normotensive controls.
Methods:
This is a longitudinal short term follow up study of 200 adult subjects with CKD and 200 each of age-matched hypertensive without CKD and apparently healthy control. Demographic information, detailed clinical profile, electrocardiography (ECG), echocardiography and 24-hr ambulatory blood pressure measurements will be obtained. Blood sample will be collected to determine albumin-creatinine ratio, fasting plasma glucose, lipid profile, electrolytes, urea and creatinine, C- reactive protein, serum homocysteine, Fibroblast growth factor -23, and full blood count, while 2 mL blood aliquot will be collected in EDTA tubes and mixed using an electronic rolling system to prevent blood clot and subsequently used for DNA extraction and genetic analysis
Results:
Two hundred and thirty-nine (239) participants have been recruited so far and it is expected that the recruitment phase will elapse in June 2020. The follow-up phase will continue with data analysis and publications of results.
Conclusions:
This study will help stratify Nigerian CKD patients phenotypically and genotypically in terms of their BP variations with implications for targeted interventions and timing of medications to improve prognosis.
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