电邮这篇文章 Hyperfiltration in hypertensive patients: results of epidemiological studies
- 作者: Arutyunov G.P.1, Oganezova L.G.1, Arutyunov GP1, Oganezova LG1
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隶属关系:
- Российский Государственный Медицинский университет
- 期: 卷 81, 编号 8 (2009)
- 页面: 24-30
- 栏目: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/30476
- ID: 30476
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Aim. To evaluate prevalence of hyperfiltration (HF) in hypertensive patients, to estimate HF correlation with main demographic, clinical and laboratory data.
Material and methods. A retrospective analysis was made by a proposed algorithm of 1160 case histories of outpatients and 1070 case histories of inpatients with hypertension. Glomerular filtration rate (GFR) was calculated by Mayo formula. 100 hypertensive patients with HF participated in telephone questionnaire survey. Also, 100 healthy medical students were examined.
Results. HF was found in 15.83% examinees with hypertension and in no healthy subjects. HF patients had a shorter history of hypertension (4.64 ± 0.97 years), less frequent affection of target organs, type 2 diabetes mellitus, circulatory insufficiency. Most of the patients were males (82.35%, p < 0.05), they were significantly younger (mean age 51.93 ± 9.85 years) than the controls. Out of HF patients, 44.48, 26.35, 27.76% had arterial hypertension of the first degree, high normal pressure and hypertension of the second degree, respectively; 37.96% hypertensive patients with hyperfiltration received no treatment. In the absence of treatment for 2 years this group of patients exhibited a 12.12% fall in GFR, a 17.85 mm Hg rise of systolic and 7.4 mm Hg of diastolic pressure, a 10-fold increase of microalbuminuria. Overweight (body mass index in HF patients 31.51 ± 16.2 kg/m2) and smoking (68%) were among factors promoting GFR acceleration.
Conclusion. Hyperfiltration develops at early stages of arterial hypertension in young patients and deteriorates prognosis. Therefore, preventive and therapeutic measures should be taken early with a focus on modification of the risk factors, first of all, obesity and smoking.
Material and methods. A retrospective analysis was made by a proposed algorithm of 1160 case histories of outpatients and 1070 case histories of inpatients with hypertension. Glomerular filtration rate (GFR) was calculated by Mayo formula. 100 hypertensive patients with HF participated in telephone questionnaire survey. Also, 100 healthy medical students were examined.
Results. HF was found in 15.83% examinees with hypertension and in no healthy subjects. HF patients had a shorter history of hypertension (4.64 ± 0.97 years), less frequent affection of target organs, type 2 diabetes mellitus, circulatory insufficiency. Most of the patients were males (82.35%, p < 0.05), they were significantly younger (mean age 51.93 ± 9.85 years) than the controls. Out of HF patients, 44.48, 26.35, 27.76% had arterial hypertension of the first degree, high normal pressure and hypertension of the second degree, respectively; 37.96% hypertensive patients with hyperfiltration received no treatment. In the absence of treatment for 2 years this group of patients exhibited a 12.12% fall in GFR, a 17.85 mm Hg rise of systolic and 7.4 mm Hg of diastolic pressure, a 10-fold increase of microalbuminuria. Overweight (body mass index in HF patients 31.51 ± 16.2 kg/m2) and smoking (68%) were among factors promoting GFR acceleration.
Conclusion. Hyperfiltration develops at early stages of arterial hypertension in young patients and deteriorates prognosis. Therefore, preventive and therapeutic measures should be taken early with a focus on modification of the risk factors, first of all, obesity and smoking.
作者简介
Grigoriy Arutyunov
Российский Государственный Медицинский университет
Email: arut@ossn.ru
Кафедра терапии Московского факультетапроф., д. м. н., зав. кафедрой; Российский Государственный Медицинский университет
Liana Oganezova
Российский Государственный Медицинский университет
Email: lianaogan@gmail.com
Кафедра терапии Московского факультетаассистент кафедры; Российский Государственный Медицинский университет
G Arutyunov
L Oganezova
参考
- Brenner B. M., Rector F. C. Jr. The kidney. 4th ed. Philadelphia: W. B. Saunders Co; 1991.
- Moss N. G., Colinders R. E., Gottschalk C. W. Neural control of renal function. In: Windhager E. E. Repal physiology. New York Oxford University Press; 1992. chapt. 22.
- Fisher N. D. L., Allan D. R., Gaboury G. L. Untrarenal A-II formation in humans: evidence from renin inhibitions. Am. J. Hypertens. 1995; 8: 152.
- Ruilope L. M., Van Veldhuisen D. J., Ritz E. et al. Renal function: the Cinderella of cardiovascular risk profile. J. Am. Coll. Cardiol. 2001; 38: 1782-1787.
- Дмитрова Т. Б., Кобалава Ж. Д., Кардиоренальный синдром. Рус. Мед. журн. 2003; 11 (12): 699.
- Cooper R. S. The JAMA peer review report, J. A. M. A. 2003; 289: 2363-2369.
- Небиеридзе Д. В. Современные принципы контроля мягкой артериальной гипертонии. Кардиология СНГ 2006; 4: 240.
- Yuyun M. F., Khaw K. T., Luben R. et al. A prospective study of microalbuminuria and incident coronary heart disease and its prognostic significance in a British population: the EPIC-Norfolk study. Am. J. Epidemiol. 2004; 159: 284-293.
- Lekatsas I., Koulouris S., Triantafyllou K. et al. Prognostic significance of microalbuminuria in non-diabetic patients with acute myocardial infarction. Int. J. Cardiol. 2006; 106 (2): 218-223.
- Szczudlik A., Turaj W., Slowik A., Strojny J. Microalbuminuria and hyperthermia independently predict long-term mortality in acute ischemic stroke patients. Acta Neurol. Scand. 2003; 107: 96-101.
- Borch-Johnsen K., Feldt-Rasmussen В., Strandgaard S. et al. Urinary albumin excretion. An independent predictor of ischemic heart disease. Arterioscler. Thomb. Vase. Biol. 1999; 19: 1992-1997.
- Brenner M. B., Meyer T. W., Hostetter Т. Н. Dietary protein intake and progressive nature of kidney disease: the role of hemodinamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis on aging, renal ablation and intrinsic renal disease. N. Engl. J. Med. 1982; 307: 652-659.
- Чазова И. Е., Ратова Л. Г. и др. Нефропротекция в лечении больных артериальной гипертонией (результаты исследования ИРИС). Нефрология 2005; 7 (1): 3-6.
- Клинические практические рекомендации по хроническому заболеванию почек: оценка, классификация и стратификация. National Kidney Foundation KDOQI; 2002. www.nepro.ru/standart/dogi_ckd/kdogicld.htm
- Keane W., Eknoyan G. Proteinuria, albuminutia, risk, assessment, detection, elimination (PARADE): position on the National Kidney Foundation. Am. J. Kidney Dis 1999; 33: 1004-1010.
- Ruilope L. M., Rodicio J. L. Microalbuminuria in clinical practice. Kidney: Curr. Surv. Wld Lit. 1995; 4: 211-216.
- Ruilope L. M., Alcazar J. M., Rodicio J. L. Renal conseguences of arterial hypertension. J. Hypertens. 1992; 10: 85-90.
- Шестакова М. В., Чугунова Л. А., Шамхалова М. Ш. и др. Диабетическая нефропатия: факторы риска быстрого прогрессирования почечной недостаточности. Тер. арх. 1999; 6: 45-49.
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