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Earlier, we demonstrated that kidney length and minimal cortex width in BEN offspring were significantly decreased if the mother had BEN [ 20].
Given that kidney dimensions correlate with the number of nephrons [ 18], our finding that minimal cortex width is significantly associated with systolic and pulse pressure supports Mackenzie's hypothesis.
Figure 2 shows the scatter plot of minimal cortex width and pulse pressure using a cubic regression with 95% confidence limits.
For the minimal cortex width, the ICC was 0.66 (lower 5% limit: 0.58) and 0.92 for kidney length (lower limit: 0.89).
In our study of adult Caucasian offspring from Bulgaria, a 5% decrease in the minimal cortex width (0.5 mm, range 10 – 20 mm) is associated with a 0.7 mm Hg increase in blood pressure.
Since we have previously reported a reduced kidney cortex width in BEN offspring [ 14], our finding that minimal cortex width is related to blood pressure is in agreement with prior reports.
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In all participants, a decrease in minimal kidney cortex width of 1 mm was related to an increase in systolic blood pressure of 1.4 mm Hg (p = 0.005).
Our findings show that a decrease of the minimal kidney cortex width of 1 mm was related to an increase in systolic blood pressure of 1.4 mm Hg.
Similarly, we have demonstrated a cubic regression between minimal kidney cortex width and blood pressure; the threshold we detected in our model, is approximately 16 mm of cortex width.
To answer the question whether minimal kidney cortex width is related to higher blood pressure, we controlled for potentially confounding factors such as gender, age, history of smoking, diabetes mellitus, parental history of hypertension or of Balkan Endemic Nephropathy, body surface area, and blood lead level.
Within the boundaries of our measurements of the cortex width there was no decrease in blood pressure once the minimal kidney cortex width was 16 mm or larger.
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