Fujimoto Tetsuya, Takechi Shigeru, Machida Maiko, Isu Nanae, Imamura Wataru, Kakinoki Shigeo, Kanda Kouichi, Kobayashi Takeshi, Nomura Akikazu
Department of Pathophysiology, School of Pharmacy, Hokkaido Pharmaceutical University, Otaru, Hokkaido, Japan.
Blood Press. 2008;17(5-6):270-3. doi: 10.1080/08037050802449418.
Hypertension causes proteinuria and is an important factor in the progress of renal dysfunction. Increases in various proteins in urine are caused by malfunction of the glomerulus and the renal tubules. In the present study, the effects of hypertension on urinary excretion levels of various proteins were investigated to show the tubular cell malfunction in hypertensive patients.
The subjects included 55 non-diabetic hypertensive patients without previous treatment and 42 normotensive individuals without microalbuminuria. Total urinary protein/creatinine ratio was measured, and urinary proteins were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE).
Total urinary protein/creatinine ratio was higher in hypertensive patients than in normotensive individuals (122.0+/-11.0 vs. 60.6+/-3.1 mg/gCr; p<0.001). SDS-PAGE resolved 15 protein fractions from the urine of both groups. Thirteen fractions were more intensely stained in samples from the hypertensive than from the normotensive. Two fractions did not differ between the groups. Hypertension increased the urinary excretion of various proteins including proteins of less than 40 kDa, called tubular proteins, in addition to albumin.
Hypertension differently influenced the excretion of each urinary protein fraction. Tubular malfunction should be considered in hypertensive patients in addition to glomerular malfunction.
高血压可导致蛋白尿,是肾功能不全进展的重要因素。尿液中各种蛋白质的增加是由肾小球和肾小管功能异常引起的。在本研究中,研究了高血压对各种蛋白质尿排泄水平的影响,以显示高血压患者的肾小管细胞功能异常。
研究对象包括55例未经治疗的非糖尿病高血压患者和42例无微量白蛋白尿的血压正常个体。测量尿总蛋白/肌酐比值,并通过十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)分析尿蛋白。
高血压患者的尿总蛋白/肌酐比值高于血压正常个体(122.0±11.0 vs. 60.6±3.1 mg/gCr;p<0.001)。SDS-PAGE从两组尿液中分离出15种蛋白组分。高血压组样本中有13个组分的染色比血压正常组更深。两组间有两个组分无差异。除白蛋白外,高血压还增加了包括分子量小于40 kDa的蛋白质(称为肾小管蛋白)在内的各种蛋白质的尿排泄量。
高血压对各尿蛋白组分的排泄有不同影响。除肾小球功能异常外,高血压患者还应考虑肾小管功能异常。