Dietary Salt Intake is a Significant Determinant of Impaired Kidney Function in the General Population

Background/Aims: Kidney dysfunction is an important risk factor for cardiovascular disease and end-stage renal disease. This study investigated whether dietary salt intake predicts deterioration of kidney function in the general population. Methods: In all, 12 126 subjects with a normal estimated glomerular filtration rate (eGFR ≥60 mL/min per 1.73m2) attending an annual check-up were enrolled in the study and were followed-up for a median of 1754 days; the endpoint was the development of impaired kidney function (eGFR < 60 mL/min per 1.73m2). Individual salt intake was estimated using spot urine analysis. Results: At baseline, mean (± SD) salt intake and eGFR were 10.6 ± 3.4 g/day and 80.8 ± 12.9 mL/min per 1.73m2, respectively. During the follow-up period, 1384 subjects (25.2 per 1000 person-years) developed impaired kidney function. Multivariate Cox hazard regression analysis revealed salt intake as a significant predictor of the new onset of kidney impairment (hazard ratio 1.045; 95% confidence interval 1.025–1.065). Subjects were divided into two groups based on salt intake; the incidence of impaired kidney function was higher in the group with high than low salt intake (P < 0.001, log-rank test). Multivariate Cox hazard regression analysis indicated a 29% increased risk of developing impaired kidney function in the high-salt group. Multivariate linear regression analysis showed a significant correlation between salt intake and yearly decline in eGFR (β = 0.060, P < 0.001). Conclusion: Salt intake is associated with the development of impaired kidney function in the general population, independent of its effects on blood pressure. Salt restriction may help prevent the development of impaired kidney function

Fractographic Identification of Fracture Origin Mainly Controlled by the Intensity of Singular Stress Field (ISSF) in Prismatic Butt Joint with Corner Fillet

In this study, the fracture origin is identified for the prismatic butt joints whose debonding condition can be expressed as a constant value of the ISSF. The ISSF variation is newly analyzed along the interface side by considering the real specimen geometry with chamfer at the corner. The detail fractographic observation shows that most of the fracture starts from the maximum ISSF region at the interface side instead of the interface corner. When the bondline thickness h is larger, the fracture origin can be seen at sub-surface because the stress triaxiality decreases inside of the specimen. The fracture origin under thermal loading can be estimated similarly because of the coincidence the ISSF variations

Variation of intensity of singular stress field (ISSF) along the interface outer edge of prismatic butt joint and debonding condition expressed by the ISSF

In our previous study, the adhesive strength of butt joints having three-dimensional (3D) geometries was investigated by using the intensity of singular stress field (ISSF) in two-dimensional modelling. In this paper, by considering the 3D geometry, the ISSF variation along the butt-joint interface side is discussed to explain the experimental results. The results show that the critical ISSF distributions when debonding occur are almost the same and independent of the adhesive bondline thickness. The validity of the 2D modelling is investigated experimentally for two kinds of brittle and ductile adhesives considering the location of the maximum ISSF. It is found that the adhesive strength can be expressed as a constant value of the ISSF at the center side and also at the corner of the adhesive interface

Blood pressure variability and the development of hypertensive organ damage in the general population

Abstract Increasing blood pressure variability (BPV) has been reported to be a strong predictor of cardiovascular events in patients with hypertension. However, the effects of BPV in the general population have not been intensively studied. The present study was designed to investigate a possible relationship between year‐to‐year BPV and hypertensive target organ damage (TOD) in a relatively low‐risk general population. A total of 5489 consecutive patients (mean age 58.6 ± 10.7 years) who visited our hospital for an annual physical checkup for five consecutive years during 2008–2013 were enrolled in this study. The average systolic and diastolic blood pressures and pulse pressure were calculated, as well as standard deviation, coefficient of variation, and average real variability in blood pressures. Cross‐sectional analysis was conducted and subjects without TOD at baseline (n = 3115) were followed up (median 1827 days) with the endpoint of TOD, defined as left ventricular hypertrophy on electrocardiogram or declining glomerular filtration rate. At baseline, BPV was closely associated with TOD. During follow‐up, left ventricular hypertrophy and declining glomerular filtration rate developed in 189 and 400 subjects, respectively. Although the standard deviation for systolic blood pressure and pulse pressure predicted future development of TOD in a univariate analysis, BPV was not a significant determinant of incident TOD in adjusted Cox hazard models. These results suggest that year‐to‐year BPV is a marker of the presence of TOD in the general population but does not independently predict future TOD