Hu Jinbo, Wang Yue, Xiang Xiaojiao, Peng Chuan, Gao Rufei, Goswami Richa, Zhou Huang, Zhang Yi, Zhen Qianna, Cheng Qingfeng, Yang Shumin, Li Qifu
aThe First Affiliated Hospital of Chongqing Medical UniversitybHospital of Chongqing University, Chongqing, China*Jinbo Hu and Yue Wang contributed equally to the writing of this article.
J Hypertens. 2016 Feb;34(2):332-7. doi: 10.1097/HJH.0000000000000780.
Hypertensive nephropathy is one of the major causes of chronic kidney disease (CKD). Bisphenol A (BPA) is associated with elevated blood pressure and urinary albuminuria. The aim of this study is to evaluate the association between serum BPA with the progression of CKD in patients with primary hypertension.
In this prospective study, 302 patients with primary hypertension were followed up for 6 years (195 men and 107 women, 65.29 ± 9.78 years at baseline). The baseline values of serum BPA were measured. Renal function was measured as estimated glomerular filtration rate (eGFR) calculated by the Chronic Kidney Disease Epidemiology Collaboration creatinine-cystatin C equation (eGFRcr-cys). Regression models were used to calculate associations of serum BPA with the annual change in eGFR and the risk of CKD progression.
Baseline serum BPA concentration was 0.61(0.26, 2.44) ng/ml and was significantly negatively correlated with the annual change in eGFR (R = -0.197, P < 0.001). After adjusting for clinical factors, baseline serum BPA level had a significant negative association with the annual change in eGFR (β = -0.132, P = 0.007). Univariate logistic regression analysis showed that the baseline age, SBP, eGFR, and serum BPA levels were predictors of CKD stage 3 or greater. In multivariate logistic regression analysis, patients with high serum BPA levels exhibited a five-fold increased risk of developing CKD stage 3 or greater compared with patients with low serum BPA levels [odds ratio 4.79 (95% confidence interval 1.81, 14.25), P = 0.004].
Serum BPA may be a predictor of CKD progression in patients with primary hypertension.
高血压肾病是慢性肾脏病（CKD）的主要病因之一。双酚A（BPA）与血压升高和尿白蛋白尿有关。本研究旨在评估原发性高血压患者血清BPA与CKD进展之间的关联。
在这项前瞻性研究中，对302例原发性高血压患者进行了6年的随访（195例男性和107例女性，基线时年龄为65.29±9.78岁）。测量血清BPA的基线值。肾功能通过慢性肾脏病流行病学协作组肌酐-胱抑素C方程计算的估计肾小球滤过率（eGFR）来衡量（eGFRcr-cys）。采用回归模型计算血清BPA与eGFR年度变化以及CKD进展风险之间的关联。
基线血清BPA浓度为0.61（0.26，2.44）ng/ml，与eGFR的年度变化呈显著负相关（R = -0.197，P < 0.001）。在调整临床因素后，基线血清BPA水平与eGFR的年度变化呈显著负相关（β = -0.132，P = 0.007）。单因素逻辑回归分析显示，基线年龄、收缩压、eGFR和血清BPA水平是CKD 3期或更高分期的预测因素。在多因素逻辑回归分析中，血清BPA水平高的患者发生CKD 3期或更高分期的风险比血清BPA水平低的患者增加了四倍[比值比4.79（95%置信区间1.81，14.25），P = 0.004]。
血清BPA可能是原发性高血压患者CKD进展的预测指标。
