Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
BMC Nephrol. 2014 Mar 10;15:44. doi: 10.1186/1471-2369-15-44.
Increasing evidence suggests that aldosterone promotes renal damage. Since data on the association between aldosterone and renal function in the general population are sparse, we chose to address this issue. We investigated the associations between the plasma aldosterone concentration (PAC) or the aldosterone-to-renin ratio (ARR) and the estimated glomerular filtration rate (eGFR) in a sample of adult men and women from Northeast Germany.
A study population of 1921 adult men and women who participated in the first follow-up of the Study of Health in Pomerania was selected. None of the subjects used drugs that alter PAC or ARR. The eGFR was calculated according to the four-variable Modification of Diet in Renal Disease formula. Chronic kidney disease (CKD) was defined as an eGFR < 60 ml/min/1.73 m2.
Linear regression models, adjusted for sex, age, waist circumference, diabetes mellitus, smoking status, systolic and diastolic blood pressures, serum triglyceride concentrations and time of blood sampling revealed inverse associations of PAC or ARR with eGFR (ß-coefficient for log-transformed PAC -3.12, p < 0.001; ß-coefficient for log-transformed ARR -3.36, p < 0.001). Logistic regression models revealed increased odds for CKD with increasing PAC (odds ratio for a one standard deviation increase in PAC: 1.35, 95% confidence interval: 1.06-1.71). There was no statistically significant association between ARR and CKD.
Our study demonstrates that PAC and ARR are inversely associated with the glomerular filtration rate in the general population.
越来越多的证据表明醛固酮可促进肾脏损伤。由于人群中醛固酮与肾功能之间关系的数据较少，因此我们选择解决这个问题。我们研究了德国东北部成年男性和女性样本中血浆醛固酮浓度（PAC）或醛固酮与肾素比值（ARR）与估算肾小球滤过率（eGFR）之间的关系。
选择了参加波美拉尼亚健康研究第一次随访的 1921 名成年男性和女性作为研究人群。研究对象均未使用改变 PAC 或 ARR 的药物。根据四变量肾脏病饮食改良公式计算 eGFR。慢性肾脏病（CKD）定义为 eGFR < 60 ml/min/1.73 m2。
调整性别、年龄、腰围、糖尿病、吸烟状况、收缩压和舒张压、血清甘油三酯浓度和采血时间后，线性回归模型显示 PAC 或 ARR 与 eGFR 呈负相关（log 转换后的 PAC 的回归系数为-3.12，p < 0.001；log 转换后的 ARR 的回归系数为-3.36，p < 0.001）。Logistic 回归模型显示，PAC 升高与 CKD 的发生几率增加相关（PAC 增加一个标准差的优势比：1.35，95%置信区间：1.06-1.71）。ARR 与 CKD 之间无统计学显著相关性。
我们的研究表明，PAC 和 ARR 与普通人群的肾小球滤过率呈负相关。
