Relationship between GFR and albuminuria in stage 1 hypertension
| Autor: | Palatini, Paolo, Mos, L, Ballerini, P, Mazzer, A, Saladini, F, Bortolazzi, A, Cozzio, S, Casiglia, Edoardo, Harvest, Investigators |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Hypertension Renal Epinephrine Epidemiology Kidney Glomerulus Renal function Blood Pressure urologic and male genital diseases Critical Care and Intensive Care Medicine Risk Factors Internal medicine Albuminuria Humans Medicine Longitudinal Studies Prospective Studies Stage (cooking) Prospective cohort study Transplantation business.industry Original Articles medicine.disease Logistic Models Blood pressure Endocrinology Nephrology Multivariate Analysis Ambulatory Disease Progression Cardiology Female Microalbuminuria medicine.symptom business Glomerular hyperfiltration Follow-Up Studies Glomerular Filtration Rate |
| Popis: | Whether glomerular hyperfiltration is implicated in the development of microalbuminuria in hypertension is not well known. This prospective study investigated the relationship between changes in GFR and microalbuminuria in hypertension.This study assessed 534 stage 1 hypertensive participants from the Hypertension and Ambulatory Recording Venetia Study (n=386 men) without microalbuminuria at baseline, who were recruited from 1990 to 1995 and followed for a median of 8.5 years. Mean age was 33.9±8.6 years and mean BP was 146.6±10.5/94.0±5.0 mmHg. Creatinine clearance and 24-hour urinary albumin were measured at study entry and end. Participants were defined as normofilterers (normo) or hyperfilterers (hyper) according to whether GFR was150 or ≥150 ml/min per 1.73 m(2), respectively. Participants were divided into four groups based on GFR changes from baseline to follow-up end: normo→normo (n=395), normo→hyper (n=31), hyper→hyper (n=61), and hyper→normo (n=47).Microalbuminuria progressively increased across the four groups and was 5.3% in normo→normo, 9.7% in normo→hyper, 16.4% in hyper→hyper, and 36.2% in hyper→normo (P0.001). This association held true in a multivariable logistic regression in which several confounders, ambulatory BP, and other risk factors were taken into account (P0.001). In particular, hyperfilterers whose GFR decreased to normal at study end had an adjusted odds ratio of 7.8 (95% confidence interval, 3.3-18.2) for development of microalbuminuria compared with participants with normal GFR throughout the study.These data support the hypothesis for a parabolic association between GFR and urinary albumin in the early stage of hypertension. |
| Databáze: | OpenAIRE |
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