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估算肾小球滤过率还是蛋白尿:哪一个与难治性高血压真正相关?

Estimated GFR or albuminuria: which one is really associated with resistant hypertension?

作者信息

Romero César A, Peixoto Aldo J, Orias Marcelo

机构信息

Hospital Privado, Córdoba, Argentina; Instituto de Investigación Médica "Mercedes y Martin Ferreyra," INIMEC-CONICET, Córdoba, Argentina.

Section of Nephrology, Yale University School of Medicine, New Haven, CT.

出版信息

Semin Nephrol. 2014;34(5):492-7. doi: 10.1016/j.semnephrol.2014.08.002.

Abstract

Patients with resistant hypertension belong to a very high cardiovascular risk group and have a high prevalence of target organ damage. Microalbuminuria and low estimated glomerular filtration rate are associated with resistant hypertension, and could be a cause and/or complication of hypertension. In this review, we explore the relationship between these 2 markers of kidney disease and the prevalence of resistant hypertension. We identified different phenotypes of resistant hypertension that associate with microalbuminuria and/or low estimated glomerular filtration rate. These phenotypes suggest that high sympathetic activity associated with fluid overload and endothelial dysfunction may contribute differently to the development of resistant hypertension.

摘要

顽固性高血压患者属于心血管风险极高的群体,且靶器官损害的患病率很高。微量白蛋白尿和低估算肾小球滤过率与顽固性高血压相关,可能是高血压的一个原因和/或并发症。在本综述中,我们探讨了这两种肾脏疾病标志物与顽固性高血压患病率之间的关系。我们确定了与微量白蛋白尿和/或低估算肾小球滤过率相关的顽固性高血压的不同表型。这些表型表明,与液体超负荷和内皮功能障碍相关的高交感神经活性可能对顽固性高血压的发展有不同的影响。

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