Lifshits N L, Kutyrina I M
Ter Arkh. 1999;71(6):64-7.
To characterize status of renin-angiotensin-aldosterone system (RAAS) in patients with chronic and terminal renal failure (CRF, TRF) and its role in pathogenesis of arterial hypertension (AH).
RAAS was studied in 90 patients with TRF on chronic hemodialysis (CHD) and 17 CRF patients with AH on conservative therapy. Plasma renin activity (PRA) and the level of plasma aldosterone (PA) were measured with radioimmunoassay.
PRA with moderate CHD-controlled hypertension (1.16 ng/ml/h) was not higher than in control group (1.33 ng/ml/h), while in severe hypertension PRA was increased 4.6-fold (6.09, p < 0.05). In CRF with severe AH PRA was higher 3.6 times (4.8 ng/ml/h, p < 0.05). PA was in CRF and TRF patients 4-5 times higher than in healthy controls. A positive correlation was found between PRA and mean dynamic AP (r = 0.448, p < 0.01) and PRA with PA (r = 0.31, p < 0.05).
A leading role of RAAS is shown in pathogenesis of AH in patients with hemodialysis uncontrolled hypertension and, partially, in patients with CRF and severe AH.
探讨慢性和终末期肾衰竭（CRF、TRF）患者肾素 - 血管紧张素 - 醛固酮系统（RAAS）的状态及其在动脉高血压（AH）发病机制中的作用。
对90例接受慢性血液透析（CHD）的TRF患者和17例接受保守治疗的CRF合并AH患者的RAAS进行研究。采用放射免疫分析法测定血浆肾素活性（PRA）和血浆醛固酮（PA）水平。
中度CHD控制高血压患者的PRA（1.16 ng/ml/h）不高于对照组（1.33 ng/ml/h），而重度高血压患者的PRA升高4.6倍（6.09，p < 0.05）。CRF合并重度AH患者的PRA高3.6倍（4.8 ng/ml/h，p < 0.05）。CRF和TRF患者的PA比健康对照组高4 - 5倍。PRA与平均动态动脉压呈正相关（r = 0.448，p < 0.01），PRA与PA呈正相关（r = 0.31，p < 0.05）。
RAAS在血液透析未控制高血压患者以及部分CRF合并重度AH患者的AH发病机制中起主导作用。
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