Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Asahi Rosai Hospital, Owariasahi, Japan.
Sci Rep. 2014 Jan 24;4:3884. doi: 10.1038/srep03884.
Kidney function and cardiovascular disease are closely connected and albuminuria is a proven marker of cardiovascular risk. The present study investigated the prevalence and characteristics of albuminuria in patients with hypertension. Outpatients with essential hypertension under medical treatment were enrolled in this study (n = 350, 70.0 ± 11.4 years old). Urine samples were collected for the measurement of albumin concentration, which are expressed as the ratio of urine albumin to creatinine concentration (mg/g Cr). Cross-sectional analyses were also performed of the relationships between urinary albumin and other variables. Urinary albumin was detected in 88.3% of patients, while only 35.4% showed abnormal albuminuria (≥30 mg/g Cr). The presence of abnormal albuminuria was independently correlated with systolic blood pressure, B-type natriuretic peptide, and C-reactive protein by multivariate analysis (P < 0.05). Furthermore, multivariate regression analysis identified systolic blood pressure, serum creatinine, B-type natriuretic peptide, and C-reactive protein as the only factors showing independent correlation with urinary albumin (P < 0.05). Thus, approximately 35% of hypertensive patients had abnormal albuminuria. Urinary albumin was closely associated with blood pressure, C-reactive protein, and B-type natriuretic peptide, indicating that the severity of albuminuria parallels that of systemic inflammation, cardiac load, and blood pressure.
肾功能与心血管疾病密切相关,而白蛋白尿是心血管风险的一个明确标志物。本研究调查了高血压患者白蛋白尿的患病率和特征。本研究纳入了接受药物治疗的特发性高血压门诊患者(n = 350,70.0 ± 11.4 岁)。收集尿液样本以测量白蛋白浓度,并用尿白蛋白与肌酐浓度的比值(mg/g Cr)表示。还进行了横断面分析,以研究尿白蛋白与其他变量之间的关系。88.3%的患者检测到尿白蛋白,而只有 35.4%的患者出现异常白蛋白尿(≥30 mg/g Cr)。多变量分析显示,异常白蛋白尿的存在与收缩压、B 型利钠肽和 C 反应蛋白独立相关(P < 0.05)。此外,多元回归分析确定收缩压、血清肌酐、B 型利钠肽和 C 反应蛋白是与尿白蛋白独立相关的唯一因素(P < 0.05)。因此,约 35%的高血压患者存在异常白蛋白尿。尿白蛋白与血压、C 反应蛋白和 B 型利钠肽密切相关,表明白蛋白尿的严重程度与全身炎症、心脏负荷和血压平行。