Päivänsalo M J, Merikanto J, Savolainen M J, Lilja M, Rantala A O, Kauma H, Reunanen A, Kesäniemi Y A, Suramo I
Department of Diagnostic Radiology, University of Oulu, Finland.
Clin Nephrol. 1998 Sep;50(3):161-8.
The aim of the study was to investigate in a population-based series (1031 subjects, age range 40-60 years) whether the renal size of hypertensive subjects differs from that of control subjects and whether the difference might be due to hypertension itself or risk factors associated with hypertension. The renal measurements were performed by abdominal ultrasound. The genders were analyzed separately. Hypertensive men had slightly larger kidneys than controls (70.1+/-8.9 cm2 vs. 67.9+/-8.7 cm2, p <0.008). The difference was, however, mediated mainly through the body mass index (BMI), whereas hypertension, blood pressure or hypertensive medication did not affect renal size. High serum concentrations of uric acid and creatinine were associated with smaller kidney size (p <0.001 and p <0.05, respectively). Alcohol users had slightly larger kidneys than abstainers, but the difference was not significant. Renal size increased with pack years of smoking. Diabetics had 4.8% larger kidneys (p <0.039), but no difference was observed between the subjects with impaired glucose tolerance and those with normal test results. In multivariate analysis, the most significant factors associated with enlarged kidney size were the fasting blood glucose concentration (p < or = 0.0001), smoking (p < or = 0.0001) and atherosclerotic lesions in carotid arteries (p <0.002). The kidneys were also slightly larger in hypertensive women than in control subjects, but the difference was only of borderline significance (p <0.08). Women on hormone replacement therapy had smaller kidneys than other women (p <0.05), but there was no difference in renal measures between premenopausal and postmenopausal women. In multivariate analysis, the most significant factors contributing to large kidney size were blood glucose concentration (p <0.0001) and smoking (p <0.05), while age and serum creatinine concentration were associated with smaller kidney size (p <0.0001 and p <0.0001). We conclude that renal size is related to sex and the subject's height and weight. Smoking, abnormal glucose tolerance, blood uric acid, creatinine, carotid atherosclerosis and hormone replacement therapy in women were also significant factors for renal size. Hypertensive subjects had larger kidneys than controls, mainly because of their more frequent obesity and abnormal glucose test.
本研究旨在调查一个基于人群的队列（1031名受试者，年龄范围40 - 60岁）中，高血压患者的肾脏大小是否与对照者不同，以及这种差异是否可能归因于高血压本身或与高血压相关的危险因素。通过腹部超声进行肾脏测量。对不同性别分别进行分析。高血压男性的肾脏略大于对照组（70.1±8.9平方厘米 vs. 67.9±8.7平方厘米，p<0.008）。然而，这种差异主要由体重指数（BMI）介导，而高血压、血压或高血压药物治疗并未影响肾脏大小。高血清尿酸和肌酐浓度与较小的肾脏大小相关（分别为p<0.001和p<0.05）。饮酒者的肾脏略大于戒酒者，但差异不显著。肾脏大小随吸烟包年数增加。糖尿病患者的肾脏大4.8%（p<0.039），但糖耐量受损者与检查结果正常者之间未观察到差异。在多变量分析中，与肾脏增大最显著相关的因素是空腹血糖浓度（p≤0.0001）、吸烟（p≤0.0001）和颈动脉粥样硬化病变（p<0.002）。高血压女性的肾脏也略大于对照者，但差异仅具有临界显著性（p<0.08）。接受激素替代疗法的女性肾脏小于其他女性（p<0.05），但绝经前和绝经后女性的肾脏测量值无差异。在多变量分析中，导致肾脏增大的最显著因素是血糖浓度（p<0.0001）和吸烟（p<0.05），而年龄和血清肌酐浓度与较小的肾脏大小相关（p<0.0001和p<0.0001）。我们得出结论，肾脏大小与性别以及受试者的身高和体重有关。吸烟、糖耐量异常、血尿酸、肌酐、颈动脉粥样硬化以及女性的激素替代疗法也是影响肾脏大小的重要因素。高血压患者的肾脏大于对照者，主要是因为他们更常出现肥胖和血糖检查异常。
