Hypertension, glomerular hypertrophy and nephrosclerosis: the effect of race
| Autor: | Victor G. Puelles, Wendy E. Hoy, Susan A. Mott, Michael D Hughson, John F. Bertram, Rebecca N. Douglas-Denton |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
Hypertension Renal Arteriosclerosis Kidney Glomerulus Blood Pressure Muscle hypertrophy Fibrosis Chronic Kidney Disease gender 10. No inequality Child race 2. Zero hunger Aged 80 and over Nephritis Age Factors Glomerular Hypertrophy Middle Aged Prognosis 3. Good health Nephrology Child Preschool Cardiology Female Autopsy glomerulosclerosis Glomerular Filtration Rate Adult medicine.medical_specialty hypertension Adolescent White People CLINICAL SCIENCE Young Adult Internal medicine Hypertensive Nephropathy medicine Humans glomerulomegaly Aged Transplantation Nephrosclerosis business.industry Infant Newborn Glomerulosclerosis Infant Hypertrophy medicine.disease Black or African American Endocrinology Blood pressure Multivariate Analysis business Body mass index |
| Zdroj: | Nephrology Dialysis Transplantation |
| ISSN: | 1460-2385 0931-0509 |
| Popis: | Background African Americans have more severe hypertensive nephrosclerosis than white Americans, possibly at similar levels of blood pressure. Glomerular volume is increased in African Americans relative to whites, but it is uncertain how this relates to nephrosclerosis and whether it contributes to or compensates for glomerulosclerosis. Methods Stereological disector/fractionator estimates of glomerular number (Nglom) and average glomerular volume (Vglom) were obtained on autopsy kidneys of 171 African Americans and 131 whites. Eighty-eight African Americans and 49 whites were identified as hypertensive. Nephrosclerosis was measured morphometrically as the percentage of glomerulosclerosis, proportion of cortical fibrosis and interlobular artery intimal thickness, and analyzed with Vglom by age, race, gender, body mass index (BMI) and blood pressure. Results African Americans were more frequently hypertensive (58.5%) than whites (35.8%) and when hypertensive had higher levels of blood pressure (P = 0.02). Nglom was significantly lower in hypertensive compared with non-hypertensive subjects among white women (P = 0.02) but not white males (P = 0.34) or African American females (P = 0.10) or males (P = 0.41). For each race and gender, glomerulosclerosis, cortical fibrosis and arterial intimal thickening were statistically correlated with age (P < 0.001) and hypertension (P < 0.001) and increased Vglom with hypertension (P < 0.001) and BMI (P < 0.001). In multivariate analysis, African American race was associated with increased Vglom (P = 0.01) and arterial intimal thickening (P < 0.01), while interactions between race and blood pressure indicated that the severity of nephrosclerosis including increased Vglom was linked most directly to hypertension without significant contributions from race. The hypertension-associated enlargement of Vglom was present with mild degrees of glomerulosclerosis and changed little as the severity of glomerulosclerosis increased. Conclusions Glomerular hypertrophy was identified as an integral feature of hypertensive nephropathy and appeared to precede rather than compensate for glomerulosclerosis. An effect of race on Vglom and arterial intimal thickening seemed to be related to the more frequent and more severe hypertension among African Americans. |
| Databáze: | OpenAIRE |
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