Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Kidney Blood Press Res. 2021;46(3):323-330. doi: 10.1159/000515527. Epub 2021 Apr 29.
Chronic mental stress is recognized as a modifiable risk factor for cardiovascular disease. The aim of this study was to demonstrate that noise annoyance-induced stress is associated with changes in renal hemodynamics.
Renal hemodynamic parameters were measured using steady-state input clearance with infusion of para-aminohippuric acid and inulin in individuals with normal, high normal, and elevated blood pressure. All individuals ranked subjective annoyance due to noise in everyday life on a 7-grade Likert scale. The median of all rankings was used as a cutoff point to divide the group into noise-annoyed and non-noise-annoyed individuals. Different renal hemodynamic parameters were calculated based on the Gomez equation.
Noise-annoyed individuals (n = 58) showed lower renal plasma flow (599 ± 106 vs. 663 ± 124 mL/min, p = 0.009), lower renal blood flow (1,068 ± 203 vs. 1,172 ± 225 mL/min, p = 0.047), higher filtration fraction (22.7 ± 3.3 vs. 21.3 ± 3.0, p = 0.012), higher renal vascular resistance (88.9 ± 25.6 vs. 75.8 ± 22.9 mm Hg/[mL/min], p = 0.002), and higher resistance of afferent arteriole (2,439.5 ± 1,253.4 vs. 1,849.9 ± 1,242.0 dyn s-1 cm-5, p = 0.001) compared to non-noise-annoyed individuals (n = 55). There was no difference in measured glomerular filtration rate (133 ± 11.8 vs. 138 ± 15 mL/min, p = 0.181), resistance of efferent arteriole (2,419.4 ± 472.2 vs. 2,245.8 ± 370.3 dyn s-1 cm-5, p = 0.060), and intraglomerular pressure (64.0 ± 3.1 vs. 64.6 ± 3.5 mm Hg, p = 0.298) between the groups. After adjusting for age, renal plasma flow, renal blood flow, and renal vascular resistance remained significantly different between the groups, with a trend in increased afferent arteriolar resistance and filtration fraction.
In this study, noise annoyance was associated with reduced renal perfusion attributed to increased renal vascular resistance predominantly at the afferent site. Long-term consequences of this renal hemodynamic pattern due to noise annoyance need to be investigated.
慢性精神压力被认为是心血管疾病的一个可改变的危险因素。本研究旨在证明噪声烦恼引起的压力与肾脏血液动力学的变化有关。
使用稳态输入清除法,通过对氨基马尿酸和菊粉输注,测量血压正常、高值和升高的个体的肾脏血液动力学参数。所有个体都对日常生活中的噪声烦恼程度进行了 7 级李克特量表评分。将所有评分的中位数作为一个截断点,将组分为噪声烦恼和非噪声烦恼个体。根据戈麦斯方程计算不同的肾脏血液动力学参数。
噪声烦恼个体(n = 58)表现出较低的肾血浆流量(599 ± 106 比 663 ± 124 mL/min,p = 0.009)、较低的肾血流量(1068 ± 203 比 1172 ± 225 mL/min,p = 0.047)、较高的滤过分数(22.7 ± 3.3 比 21.3 ± 3.0,p = 0.012)、较高的肾血管阻力(88.9 ± 25.6 比 75.8 ± 22.9 mm Hg/[mL/min],p = 0.002)和较高的入球小动脉阻力(2439.5 ± 1253.4 比 1849.9 ± 1242.0 dyn s-1 cm-5,p = 0.001),与非噪声烦恼个体(n = 55)相比。两组之间的肾小球滤过率(133 ± 11.8 比 138 ± 15 mL/min,p = 0.181)、出球小动脉阻力(2419.4 ± 472.2 比 2245.8 ± 370.3 dyn s-1 cm-5,p = 0.060)和肾小球内压(64.0 ± 3.1 比 64.6 ± 3.5 mm Hg,p = 0.298)无差异。在调整年龄、肾血浆流量、肾血流量和肾血管阻力后,两组间的差异仍然显著,入球小动脉阻力和滤过分数呈增加趋势。
在这项研究中,噪声烦恼与肾脏灌注减少有关,这归因于肾血管阻力的增加,主要发生在入球部位。由于噪声烦恼导致这种肾脏血液动力学模式的长期后果需要进一步研究。