{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:04:04Z","timestamp":1789736644272,"version":"4.0.1"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T00:00:00Z","timestamp":1567123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008868","name":"Jiangsu Science and Technology Department","doi-asserted-by":"publisher","award":["BE2017762"],"award-info":[{"award-number":["BE2017762"]}],"id":[{"id":"10.13039\/501100008868","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Impaired orthostatic blood pressure (BP) stabilization is prevalent in patients with chronic kidney disease (CKD) and is associated with adverse outcomes. We aimed to test the hypothesis that reduced hemoglobin is an important contributor to orthostatic intolerance in CKD in the present study. This study included 262 patients with non\u2010dialysis\u2010dependent CKD. Seated and standing BP was measured, and orthostatic BP reduction was calculated for both systolic BP (\u2206 SBP) and diastolic BP (\u2206 DBP). The association between orthostatic BP reduction and hemoglobin was determined by multiple linear regression models. We also performed mediation analysis to test to what extent the effect of renal dysfunction on impaired orthostatic BP stabilization can be explained by reduced hemoglobin. The mean age of the patients was 57.7 (\u00b114.5)\u00a0years, and 61.5% were male. Both \u2206 SBP and \u2206 DBP correlated negatively with estimated glomerular filtration rate (eGFR). With adjustment for age and sex, hemoglobin level was negatively associated with \u2206 SBP (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22121.4, SE\u00a0=\u00a00.4, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and \u2206 DBP (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22120.6, SE\u00a0=\u00a00.2, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.009). The associations remained significant with further adjustment for additional covariates. When eGFR was introduced as a covariate, it did not eliminate the significance (both <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). The associations remained essentially unchanged in a sensitivity analysis excluding those with concurrent erythropoietin use. Mediation analysis demonstrated that reduced hemoglobin accounted for 35.4% (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.004) of the effect of eGFR on \u2206 SBP and 47.7% (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.032) on \u2206 DBP. Our study suggests that reduced hemoglobin is a potentially important contributor to the development of orthostatic hypotension in CKD.<\/jats:p>","DOI":"10.1111\/jch.13658","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T06:18:49Z","timestamp":1567232329000},"page":"1317-1324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Impaired orthostatic blood pressure stabilization and reduced hemoglobin in chronic kidney disease"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2673-5262","authenticated-orcid":false,"given":"Wenjin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Radiology University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Kidney Disease Second Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqin","family":"Huang","sequence":"additional","affiliation":[{"name":"Center for Kidney Disease Second Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weichun","family":"He","sequence":"additional","affiliation":[{"name":"Center for Kidney Disease Second Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongwei","family":"Song","sequence":"additional","affiliation":[{"name":"Center for Kidney Disease Second Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junwei","family":"Yang","sequence":"additional","affiliation":[{"name":"Center for Kidney Disease Second Affiliated Hospital of Nanjing Medical University Nanjing 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