Whole Exome Sequencing in CKD Hypertension

NCT ID: NCT03718585

Last Updated: 2018-10-24

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 4000 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2018-06-01
• Study Completion Date: 2022-10-31

Brief Summary

The prevalence of hypertension in patients with CKD in China is high but the control rate is low. Compared with the single blood pressure measurement method of the blood pressure of the office, ambulatory blood pressure monitoring (ABPM) can reflect the overall situation of 24-hour blood pressure, dynamic fluctuation degree and circadian rhythm change more completely and objectively. Studies have shown that patients with CKD with hypertension have their own uniqueness through ABPM measurement, and nocturnal hypertension is the main cause of poor blood pressure control. Further studies have shown that nocturnal hypertension is an independent and more effective prognostic indicator of death and CVD in patients with hypertension. Evidence from European and American countries suggests that in the CKD population, elevated nighttime blood pressure is more predictive of CKD progression or CVD than daytime blood pressure. Compared with countries such as Europe and the United States, there are differences in the causes, genetic background and daily behaviors of kidney disease in our population. It is urgent to investigate the predictive value of nocturnal hypertension for renal end point and CVD in CKD population in China. To this end, our study found for the first time that CKD patients generally have changes in nocturnal blood pressure patterns, and the anti-dope type blood pressure pattern is closely related to the target organ damage. Our further study found that the incidence of nocturnal hypertension in Chinese patients with CKD is more than 50%, and compared with non-dipping blood pressure, patients with nocturnal hypertension have more serious target organ damage, which is independent risk factors for all-cause death, cardiovascular death, renal events, and cardiovascular events in patients with CKD. These preliminary results suggest the role of nocturnal hypertension in the prognosis of CKD patients in China, but there are still the following questions: Is the occurrence of nocturnal hypertension in CKD patients related to certain gene expression? This project intends to perform whole-genome exon sequencing and analysis on CKD patients with nocturnal hypertension to determine the genetic mechanism of CKD patients with nocturnal hypertension. The completion of the subject will reveal the genetic characteristics of CKD patients with nocturnal hypertension, and provide a basis for the precise prevention and treatment of chronic kidney disease hypertension.

Conditions

Hypertension;Nephropathy

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

nocturnal group

Chronic kidney disease patients with nocturnal hypertension

whole exome sequencing analysis

Intervention Type: OTHER

Collecting peripheral blood samples (2 ml) from subjects for whole exome sequencing

non-nocturnal group

Chronic kidney disease patients without nocturnal hypertension

whole exome sequencing analysis

Intervention Type: OTHER

Collecting peripheral blood samples (2 ml) from subjects for whole exome sequencing

non-CKD group

patients without chronic kidney disease

whole exome sequencing analysis

Intervention Type: OTHER

Collecting peripheral blood samples (2 ml) from subjects for whole exome sequencing

Interventions

whole exome sequencing analysis

Collecting peripheral blood samples (2 ml) from subjects for whole exome sequencing

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. Age over 14 years old and <75years.

2. The clinical data during the hospitalization period are detailed and complete.

3. Follow-up information is available.

4. Ambulatory blood pressure monitoring indicates nighttime blood pressure SBP≥120mmHg and/or DBP≥70mmHg.

5. Diagnosed as CKD according to the 2012 KDIGO guidelines, abnormalities of kidney structure or function, present for >3 months, with implications for health, including glomerular filtration rate (GFR) normal and abnormal pathological damage, blood (abnormal electrolyte or other components caused by renal tubular dysfunction) or urine components (proteinuria: ACR ≥ 30mg / gCr; other abnormal urine components) abnormal, and imaging abnormalities; or unexplained GFR decline (< 60 ml/min/1.73 m2); and eGFR ≥ 30 ml/min/1.73 m2.

Exclusion Criteria

1. pregnancy.

2. combined tumors.

3. There is a history of drug abuse or alcohol abuse.

4. There are serious infections recently.

5. Life expectancy is less than half a year.

6. Renal replacement therapy has been performed.

7. Acquired immunodeficiency syndrome.

8. Those who are being treated with cortisol hormones.

9. Those who study or work at night for a long time and have irregular rest.

10. Those who cannot cooperate or are unable to tolerate ambulatory blood pressure monitors.

• Minimum Eligible Age: 14 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Third Affiliated Hospital, Sun Yat-Sen University

OTHER

Sponsor Role: collaborator

Fifth Affiliated Hospital, Sun Yat-Sen University

OTHER

Sponsor Role: lead

Responsible Party

Cheng Wang

Director of Nephrology

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Cheng Wang, Director

Role: PRINCIPAL_INVESTIGATOR

Nephrology Department, the Fifth Affiliated Hospital of Sun Yat-sen University

Locations

Fifth Affiliated Hospital, Sun Yat-Sen University

Zhuhai, Guangdong, China

Site Status: RECRUITING

Countries

China

Central Contacts

Jianting Ke, Doctor

Role: CONTACT

kjt1997@163.com

0086 756 2528953

Facility Contacts

Cheng Wang, Director

Role: primary

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Other Identifiers

ZDWY.SNK.001

Identifier Type: -

Identifier Source: org_study_id