Kontessis P S, Friedman R, Tariq T, Moro F, Williams D G, Hartley R B, Viberti G C
Unit for Metabolic Medicine, Guy's Hospital, UMDS, London, UK.
Exp Nephrol. 1994 May-Jun;2(3):176-81.
We measured Na+/Li+ CT in 16 IgA nephropathy patients. Records were reviewed (mean observation period 5.5 years) for serial measurements of blood pressure (BP), urinary protein excretion, GFR (51Cr-EDTA) and plasma creatinine. Na+/Li+ CT correlated with the slope of the plot of GFR versus time (rs = -0.66, p = 0.005) systolic BP at diagnosis (rs = 0.62, p = 0.011) and both systolic and diastolic BP at the end of follow-up (rs = 0.69, p = 0.003, and rs = 0.56, p = 0.023). A diastolic blood pressure (DBP) > or = 95 mm Hg was associated with a faster rate of GFR decline (rate of change of GFR: -0.40 vs. -0.14 ml/min/month, p = 0.07; for DBP > or = 95 vs. < 95 mm Hg, respectively). In a multiple regression analysis with the rate of decline of GFR as dependent variable, Na+/Li+ CT emerged as a significant and independent determinant of the rate of fall of GFR (beta coefficient -1.56, SE beta 0.49, p = 0.006) and explained 52.7% of the variation in the GFR fall. Higher activities of Na+/Li+ CT are significantly associated with an increased rate of deterioration of renal function in IgA nephropathy; part of this effect could be mediated by higher blood pressure values.
我们对16例IgA肾病患者进行了钠/锂协同转运体（Na+/Li+ CT）测定。回顾了这些患者的记录（平均观察期5.5年），以获取血压（BP）、尿蛋白排泄、肾小球滤过率（GFR，采用51Cr - 乙二胺四乙酸法测定）和血肌酐的系列测量值。Na+/Li+ CT与GFR随时间变化的曲线斜率相关（rs = -0.66，p = 0.005）、诊断时的收缩压相关（rs = 0.62，p = 0.011）以及随访结束时的收缩压和舒张压相关（rs = 0.69，p = 0.003，rs = 0.56，p = 0.023）。舒张压（DBP）≥95 mmHg与GFR下降速度更快相关（GFR变化率：分别为-0.40与-0.14 ml/min/月，p = 0.07；DBP≥95 mmHg与＜95 mmHg相比）。在以GFR下降率作为因变量的多元回归分析中，Na+/Li+ CT是GFR下降率的一个显著且独立的决定因素（β系数-1.56，标准误β 0.49，p = 0.006），并解释了GFR下降变异的52.7%。较高的Na+/Li+ CT活性与IgA肾病患者肾功能恶化速度加快显著相关；这种作用部分可能由较高的血压值介导。
