Ritz E, Nowicki M, Fliser D, Hörner D, Klimm H P
Department of Internal Medicine, Ruperto Carola University, Heidelberg, Germany.
Kidney Int Suppl. 1994 Nov;47:S76-80.
Albuminuria is more prevalent in patients with primary hypertension than in normotensive subjects of the general population. The presence of albuminuria predicts the presence of more severe target organ damage and is related to the risk of cardiovascular events. Preliminary results show albuminuria even in some normotensive individuals with a genetic risk of hypertension and in association with insulin resistance. While albuminuria is generally more frequent in the elderly, it is also found in young patients with mild to moderate primary hypertension. It is uncertain whether in these circumstances albuminuria indicates some "renal component" in the etiology of primary hypertension. Massive albuminuria may occur in subjects with "benign" nephrosclerosis. Whether albuminuria is a predictor of hypertensive renal damage requires further study. Albuminuria is reduced by antihypertensive treatment, but diverse effects on albuminuria are seen with different antihypertensive agents.
蛋白尿在原发性高血压患者中比在普通人群的血压正常者中更为普遍。蛋白尿的存在预示着更严重的靶器官损害的存在，并且与心血管事件的风险相关。初步结果显示，即使在一些有高血压遗传风险且伴有胰岛素抵抗的血压正常个体中也存在蛋白尿。虽然蛋白尿在老年人中通常更常见，但在轻度至中度原发性高血压的年轻患者中也有发现。在这些情况下，蛋白尿是否表明原发性高血压病因中的某种“肾脏因素”尚不确定。“良性”肾硬化患者可能会出现大量蛋白尿。蛋白尿是否为高血压肾损害的预测指标需要进一步研究。降压治疗可减少蛋白尿，但不同的降压药物对蛋白尿有不同的影响。
