Baldoncini R, Desideri G, Bellini C, Valenti M, De Mattia G, Santucci A, Ferri C
University of Rome La Sapienza, I Clinica Medica, Andrea Cesalpino Foundation, Rome, Italy.
Kidney Int. 1999 Oct;56(4):1499-504. doi: 10.1046/j.1523-1755.1999.00672.x.
Several studies suggest that the hyperactivity of the circulating renin-angiotensin system might favor the progression of renal disease in essential hypertension. To elucidate this aspect, we investigated the relationship between plasma renin activity (PRA) and the urinary albumin excretion rate (UAER), an early marker of hypertension-related renal changes, in human essential hypertension.
Ninety nonobese, nondiabetic, nonhyperlipidemic patients with mild-to-moderate essential hypertension (67 males, 23 females; mean age 51.4 +/- 6.2 years) were divided into low renin (LR), normal renin (NR), and high renin (HR) subgroups according to individual PRA while they were on a constant NaCl intake (120 mmol NaCl/day). The UAER was assessed during the same NaCl intake.
Data showed significantly higher UAER (31.3 +/- 12.9 microg/min) in HR (N = 30) than NR (N = 30, 22.7 +/- 14.4 microg/min, P < 0.02) and LR patients (N = 30, 21.7 +/- 10.8 microg/min, P < 0. 01).
Our study demonstrates that the UAER is elevated in HR essential hypertensive patients, suggesting that high PRA accelerates the onset of early renal changes in human essential hypertension.
多项研究表明，循环肾素 - 血管紧张素系统的活性亢进可能有利于原发性高血压患者肾脏疾病的进展。为阐明这一问题，我们在人类原发性高血压患者中研究了血浆肾素活性（PRA）与尿白蛋白排泄率（UAER）之间的关系，尿白蛋白排泄率是高血压相关肾脏改变的早期标志物。
90例非肥胖、非糖尿病、非高脂血症的轻至中度原发性高血压患者（男性67例，女性23例；平均年龄51.4±6.2岁）在恒定氯化钠摄入量（120 mmol氯化钠/天）的情况下，根据个体PRA分为低肾素（LR）、正常肾素（NR）和高肾素（HR）亚组。在相同氯化钠摄入量期间评估UAER。
数据显示，HR组（N = 30）的UAER（31.3±12.9微克/分钟）显著高于NR组（N = 30，22.7±14.4微克/分钟，P < 0.02）和LR组患者（N = 30，21.7±10.8微克/分钟，P < 0.01）。
我们的研究表明，HR原发性高血压患者的UAER升高，提示高PRA加速了人类原发性高血压早期肾脏改变的发生。
