新诊断高血压患者的肾功能评估——高尿酸血症作为慢性肾脏病危险因素的作用——初步研究

The assessment of renal function in patients with newly diagnosed hypertension - the role of hyperuricemia as a risk factor for chronic kidney disease - preliminary study.

作者信息

Komendarek-Kowalska Monika

机构信息

Medical Centre in Pabianice, 3rd District Out-patient Clinic.

出版信息

Pol Merkur Lekarski. 2017 May 23;42(251):193-196.

PMID:28557965

Abstract

UNLABELLED

For the last few years, the role of uric acid in the pathogenesis of the hypertension and chronic kidney disease has drawn attention due to the increasing prevalence of the aforementioned states. Uric acid (UA), formed as a result of purine metabolism, is subject in the renal proximal tubule to filtration, reabsorption and secretion. The mechanisms of deleterious effect of UA on the kidney involve endothelial damage and the increment of hydrostatic pressure in the glomerulus which in turn lead to hypertrophy and glomerulosclerosis. Moreover, abnormally elevated levels of uric acid results in the activation of renin-angiotensinaldosterone system and thus it may be associated with disturbances of water and electrolyte balance and the appearance of hypertension.

AIM

The aim of this study was to assess the prevalence of hyperuricemia in patients with newly diagnosed hypertension and its effect on renal function.

MATERIALS AND METHODS

This is a retrospective study including 315 hypertensive patients (157 women - 49.8% and 158 men - 50.2%, aged 39.3 ± 14.0 years) hospitalized in the Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz (study group) and 181 individuals without hypertension (103 women - 56.9% and 78 men - 43.1%, aged 42.4 ± 14.0) (control group).

RESULTS

Hyperuricemia was observed in 6.7% of patients with newly diagnosed hypertension. A positive correlation between serum creatinine and uric acid (Spearman coefficient 0.426, p<0.0001) and negative correlation between uric acid and eGFR (Spearman coefficient -0.116, p =0.068) were demonstrated in this study.

CONCLUSIONS

Patients with newly diagnosed hypertension have higher levels of uric acid in comparison to control group. Elevated levels of uric acid can influence the development of hypertension and aggravate hypertension-associated renal damage.

摘要

未标注

在过去几年中，由于高血压和慢性肾病的患病率不断上升，尿酸在其发病机制中的作用引起了关注。尿酸（UA）是嘌呤代谢的产物，在肾近端小管中会经历滤过、重吸收和分泌过程。尿酸对肾脏产生有害影响的机制包括内皮损伤以及肾小球内静水压升高，进而导致肾小球肥大和肾小球硬化。此外，尿酸水平异常升高会激活肾素 - 血管紧张素 - 醛固酮系统，因此可能与水和电解质平衡紊乱以及高血压的出现有关。

目的

本研究旨在评估新诊断高血压患者中高尿酸血症的患病率及其对肾功能的影响。

材料与方法

这是一项回顾性研究，纳入了罗兹瓦姆大学医院肾脏病、高血压与家庭医学科收治的315例高血压患者（157名女性 - 49.8%，158名男性 - 50.2%，年龄39.3±14.0岁）（研究组）以及181名无高血压的个体（103名女性 - 56.9%，78名男性 - 43.1%，年龄42.4±14.0岁）（对照组）。