TY - JOUR
T1 - Interaction of neutrophil counts and folic acid treatment on new-onset proteinuria in hypertensive patients
AU - Zhang, Zhuxian
AU - Liu, Mengyi
AU - Zhang, Yuanyuan
AU - Zhou, Chun
AU - He, Panpan
AU - Li, Huan
AU - Li, Jianping
AU - Zhang, Yan
AU - Liang, Min
AU - Wang, Binyan
AU - Xu, Xin
AU - Wang, Xiaobin
AU - Huo, Yong
AU - Hou, Fan Fan
AU - Nie, Jing
AU - Xu, Xiping
AU - Qin, Xianhui
N1 - Funding Information:
The study was supported by the National Key Research and Development Program (2016YFE0205400, 2018ZX09739010, 2018ZX09301034003); the Science and Technology Planning Project of Guangzhou, China (201707020010); the Science, Technology and Innovation Committee of Shenzhen (JSGG20170412155639040, GJHS20170314114526143, JSGG 20180703155802047); the Economic, Trade and Information Commission of Shenzhen Municipality (20170505161556110, 20170505160926390); and the National Natural Science Foundation of China (81973133, 81730019, 81521003).
Funding Information:
Xiping Xu reports grants from the National Key Research and Development Program (2016YFE0205400, 2018ZX09739010, 2018ZX09301034003), the Science and Technology Planning Project of Guangzhou, China (201707020010), the Science, Technology and Innovation Committee of Shenzhen (JSGG 20170412155639040, GJHS20170314114526143, JSGG2018070 3155802047), and the Economic, Trade and Information Commission of Shenzhen Municipality (20170505161556110, 20170505160926390). X. Q. reports grants from the National Natural Science Foundation of China (81973133, 81730019). J. N. reports grants from Nature and Science Foundation of China (81730019, 81521003). No other disclosures were reported.
Publisher Copyright:
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society.
PY - 2021/10/14
Y1 - 2021/10/14
N2 - We aimed to examine whether baseline neutrophil counts affected the risk of new-onset proteinuria in hypertensive patients, and, if so, whether folic acid treatment is particularly effective in proteinuria prevention in such a setting. A total of 8208 eligible participants without proteinuria at baseline were analysed from the renal substudy of the China Stroke Primary Prevention Trial. Participants were randomised to receive a double-blind daily treatment of 10 mg of enalapril and 0.8 mg of folic acid (n 4101) or 10 mg of enalapril only (n 4107). The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. The mean age of the participants was 59.5 (sd, 7.4) years, 3088 (37.6 %) of the participants were male. The median treatment duration was 4.4 years. In the enalapril-only group, a significantly higher risk of new-onset proteinuria was found among participants with higher neutrophil counts (quintile 5; ≥4.8 × 109/l, OR 1.44; 95 % CI 1.00, 2.06), compared with those in quintiles 1-4. For those with enalapril and folic acid treatment, compared with the enalapril-only group, the new-onset proteinuria risk was reduced from 5.2 to 2.8 % (OR 0.49; 95 % CI 0.29, 0.82) among participants with higher neutrophil counts (≥4.8 × 109/l), whereas there was no significant effect among those with neutrophil counts <4.8 × 109/l. In summary, among hypertensive patients, those with higher neutrophil counts had increased risk of new-onset proteinuria, and this risk was reduced by 51 % with folic acid treatment.
AB - We aimed to examine whether baseline neutrophil counts affected the risk of new-onset proteinuria in hypertensive patients, and, if so, whether folic acid treatment is particularly effective in proteinuria prevention in such a setting. A total of 8208 eligible participants without proteinuria at baseline were analysed from the renal substudy of the China Stroke Primary Prevention Trial. Participants were randomised to receive a double-blind daily treatment of 10 mg of enalapril and 0.8 mg of folic acid (n 4101) or 10 mg of enalapril only (n 4107). The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. The mean age of the participants was 59.5 (sd, 7.4) years, 3088 (37.6 %) of the participants were male. The median treatment duration was 4.4 years. In the enalapril-only group, a significantly higher risk of new-onset proteinuria was found among participants with higher neutrophil counts (quintile 5; ≥4.8 × 109/l, OR 1.44; 95 % CI 1.00, 2.06), compared with those in quintiles 1-4. For those with enalapril and folic acid treatment, compared with the enalapril-only group, the new-onset proteinuria risk was reduced from 5.2 to 2.8 % (OR 0.49; 95 % CI 0.29, 0.82) among participants with higher neutrophil counts (≥4.8 × 109/l), whereas there was no significant effect among those with neutrophil counts <4.8 × 109/l. In summary, among hypertensive patients, those with higher neutrophil counts had increased risk of new-onset proteinuria, and this risk was reduced by 51 % with folic acid treatment.
KW - Folic acid
KW - Hypertension
KW - Neutrophil counts
KW - New-onset proteinuria
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U2 - 10.1017/S000711452000505X
DO - 10.1017/S000711452000505X
M3 - Article
C2 - 33308359
AN - SCOPUS:85097748819
VL - 126
SP - 1040
EP - 1047
JO - British Journal of Nutrition
JF - British Journal of Nutrition
SN - 0007-1145
IS - 7
ER -