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肾酶是一种新型血压调节因子,肾移植受者的肾功能可预测其水平。

Renalase, a novel regulator of blood pressure, is predicted by kidney function in renal transplant recipients.

作者信息

Malyszko J, Zbroch E, Malyszko J S, Koc-Zorawska E, Mysliwiec M

机构信息

Department of Nephrology and Transplantology, Medical University, Bialystok, Poland.

出版信息

Transplant Proc. 2011 Oct;43(8):3004-7. doi: 10.1016/j.transproceed.2011.08.032.

Abstract

BACKGROUND

Renalase is an enzyme that catabolizes catecholamines such as adrenaline and noradrenaline in the circulation. The human kidney releases this protein into the bloodstream to regulate blood pressure. In kidney transplant recipients, the prevalence of hypertension is 60%-80%.

OBJECTIVE

The aim of our study was to assess possible correlations between renalase, blood pressure, and kidney function among 89 prevalent kidney allograft recipients. To obtain normal ranges, we also studied renalase levels in 27 healthy volunteers.

METHODS

Complete blood counts, urea, serum lipids, fasting glucose, and creatinine were measured by standard laboratory methods in the hospital central laboratory. Renalase was assessed with the use of a commercially available kit.

RESULTS

In kidney transplant recipients renalase was significantly higher than in healthy volunteers (P<.001). In kidney transplant recipients, renalase correlated with age (r=0.29; P<.05), time after transplantation (r=0.34; P<.01), systolic blood pressure (r=0.28; P<.05), diastolic blood pressure (r=0.27; P<.05), serum creatinine (r=0.49; P<.001), estimated glomerular filtration rate (Chronic Kidney Disease Endemiology collaboration: r=-0.44; P<.0001; Modification of Diet in Renal Disease: r=-0.43; P<.001; Cockcroft-Gault r=-0.39; P<.01), serum phosphate (r=0.34; P<.05). Upon multiple regression analysis renalase was predicted by 70% using age (beta value 0.21, P=0.043), time after transplantation (beta value, 0.22; P=.037), serum creatinine (beta value, 0.50; P=.016), and diastolic blood pressure (beta value, 0.33; P=.027).

CONCLUSIONS

Renalase is highly elevated in kidney transplant recipients, predominantly dependent on kidney function, which deteriorates with time after kidney transplantation and age. Further studies are needed to establish its putative role in the pathogenesis of hypertension after transplantation and possible novel targeted therapies.

摘要

背景

肾酶是一种可分解循环中的儿茶酚胺(如肾上腺素和去甲肾上腺素)的酶。人类肾脏将这种蛋白质释放到血液中以调节血压。在肾移植受者中,高血压的患病率为60%-80%。

目的

我们研究的目的是评估89例现存肾移植受者中肾酶、血压和肾功能之间可能存在的相关性。为了获得正常范围,我们还研究了27名健康志愿者的肾酶水平。

方法

在医院中心实验室采用标准实验室方法测量全血细胞计数、尿素、血脂、空腹血糖和肌酐。使用市售试剂盒评估肾酶。

结果

肾移植受者的肾酶水平显著高于健康志愿者(P<0.001)。在肾移植受者中,肾酶与年龄(r=0.29;P<0.05)、移植后时间(r=0.34;P<0.01)、收缩压(r=0.28;P<0.05)、舒张压(r=0.27;P<0.05)、血清肌酐(r=0.49;P<0.001)、估计肾小球滤过率(慢性肾脏病流行病学合作组:r=-0.44;P<0.0001;肾脏病饮食改良公式:r=-0.43;P<0.001;Cockcroft-Gault公式:r=-0.39;P<0.01)、血清磷(r=0.34;P<0.05)相关。多元回归分析显示,70%的肾酶水平可通过年龄(β值0.21,P=0.043)、移植后时间(β值0.22;P=0.037)、血清肌酐(β值0.50;P=0.016)和舒张压(β值0.33;P=0.027)预测。

结论

肾移植受者的肾酶水平显著升高,主要依赖于肾功能,而肾功能会随着肾移植后的时间和年龄增长而恶化。需要进一步研究以确定其在移植后高血压发病机制中的假定作用以及可能的新型靶向治疗方法。

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