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慢性肾脏病非透析患者的血压盐敏感性。

Salt sensitivity of blood pressure in non-dialysis patients with chronic kidney disease.

机构信息

Department of Nephrology, Second Affiliated Hospital to Tianjin University of Traditional Chinese Medicine , Tianjin , China.

出版信息

Ren Fail. 2014 Apr;36(3):345-50. doi: 10.3109/0886022X.2013.866008. Epub 2013 Dec 17.

Abstract

BACKGROUND

Chronic kidney disease (CKD) is a world-wide public health problem. Hypertension is both a cause and a complication of CKD, and a risk factor for progression of kidney disease. The effect of salt intake on blood pressure (BP) and the salt sensitivity in non-dialysis patients with CKD were studied.

METHODS

One hundred and thirty non-dialysis patients with CKD were enrolled in the present study. Daily urinary excretion of sodium (representative of daily sodium intake) and BP was monitored in conditions of original eating habits. Estimated glomerular filtration rate (eGFR) was measured by the creatinine clearance (Ccr).

RESULTS

There was a linear positive relationship between the salt intake and systolic blood pressure (SBP) (β = 0.250, p = 0.004). It had been found that the log of BP/24-h urinary sodium (salt sensitivity index) had linear relationship with the log of eGFR (βsyst = -0.364, p = 0.000, βdiast = -0.345, p = 0.000, respectively). Multi-stepwise regression analysis showed SBP was mainly influenced by salt intake and eGFR. There was a negative correlation between diastolic blood pressure (DBP) and age.

CONCLUSION

These results demonstrated a linear relationship between the salt intake and SBP in non-dialysis patients with CKD. The salt sensitivity of BP rose with the decline of renal function.

摘要

背景

慢性肾脏病(CKD)是一个全球性的公共卫生问题。高血压既是 CKD 的病因又是其并发症,也是肾脏病进展的危险因素。本研究旨在探讨盐摄入量对血压(BP)的影响及非透析 CKD 患者的盐敏感性。

方法

本研究纳入了 130 名非透析 CKD 患者。在保持原有饮食习惯的情况下,监测每日尿钠排泄量(代表每日钠摄入量)和血压。采用肌酐清除率(Ccr)估算肾小球滤过率(eGFR)。

结果

盐摄入量与收缩压(SBP)呈线性正相关(β=0.250,p=0.004)。BP/24 小时尿钠的对数值(盐敏感指数)与 eGFR 的对数值呈线性关系(βsyst=-0.364,p=0.000;βdiast=-0.345,p=0.000)。多步逐步回归分析显示,SBP 主要受盐摄入量和 eGFR 影响。舒张压(DBP)与年龄呈负相关。

结论

本研究表明,非透析 CKD 患者的盐摄入量与 SBP 呈线性关系。BP 的盐敏感性随肾功能下降而升高。

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