Messerli F H, Frohlich E D, Dreslinski G R, Suarez D H, Aristimuno G G
Ann Intern Med. 1980 Dec;93(6):817-21. doi: 10.7326/0003-4819-93-6-817.
We measured glomerular filtration rate, renal and systemic hemodynamics, and intravascular volume in normotensive subjects and in borderline and established essential hypertensive patients classified according to serum uric acid level. Renal blood flow was lower and renal vascular and total peripheral resistances were increased in patients with high uric acid levels (p < 0.02). Serum uric acid concentration correlated inversely with renal blood flow/m2 body surface area (r = -0.45, p < 0.001) and directly with renal vascular (r = 0.41, p < 0.001) and total (r = 0.38, p < 0.001) resistance. Cardiac output, heart rate, and intravascular volume as well as glomerular filtration rate showed no uric-acid-department pattern. Mild asymptomatic hyperuricemia, therefore, was associated with decreased renal blood flow without affecting glomerular filtration rate. Increased renal vascular and total peripheral resistances reflecting renal and systemic hypertensive vascular disease paralleled the rising serum uric acid levels. These data suggest that heretofore unexplained hyperuricemia in patients with essential hypertension most likely reflects early renal vascular involvement, specially, nephrosclerosis.
我们测量了血压正常的受试者以及根据血清尿酸水平分类的临界和确诊原发性高血压患者的肾小球滤过率、肾和全身血流动力学以及血管内容量。尿酸水平高的患者肾血流量较低，肾血管阻力和总外周阻力增加（p < 0.02）。血清尿酸浓度与每平方米体表面积的肾血流量呈负相关（r = -0.45，p < 0.001），与肾血管阻力（r = 0.41，p < 0.001）和总阻力（r = 0.38，p < 0.001）呈正相关。心输出量、心率、血管内容量以及肾小球滤过率均未显示出尿酸分组模式。因此，轻度无症状高尿酸血症与肾血流量减少相关，而不影响肾小球滤过率。反映肾和全身性高血压血管疾病的肾血管阻力和总外周阻力增加与血清尿酸水平升高平行。这些数据表明，原发性高血压患者迄今无法解释的高尿酸血症很可能反映了早期肾血管受累，特别是肾硬化。
