Global REACH 2018: volume regulation in high-altitude Andeans with and without chronic mountain sickness
| Autor: | Gustavo Vizcardo-Galindo, Tony G. Dawkins, Christopher Gasho, Victoria L Meah, Michael M. Tymko, Andrew R. Steele, Alexandra M. Williams, Craig D. Steinback, Francisco C. Villafuerte, Lydia L. Simpson, Philip N. Ainslie, Mike Stembridge, Jonathan P. Moore, Rómulo Figueroa-Mujíca |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Physiology Acclimatization Renal function Blood volume Polycythemia Altitude Sickness Pulmonary Artery Kidney health services administration Physiology (medical) Internal medicine Natriuretic Peptide Brain Renin Albuminuria Humans Medicine Arterial Pressure High-altitude Aldosterone health care economics and organizations Maladaptation Blood Volume Proteinuria business.industry Volume regulation Altitude Middle Aged Effects of high altitude on humans medicine.disease Peptide Fragments Chronic mountain sickness Volume (thermodynamics) Chronic Disease Cardiology medicine.symptom business Biomarkers Glomerular Filtration Rate |
| Zdroj: | American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 321:R504-R512 |
| ISSN: | 1522-1490 0363-6119 |
| DOI: | 10.1152/ajpregu.00102.2021 |
| Popis: | The high-altitude maladaptation syndrome known as chronic mountain sickness (CMS) is characterized by polycythemia and is associated with proteinuria despite unaltered glomerular filtration rate. However, it remains unclear if indigenous highlanders with CMS have altered volume regulatory hormones. We assessed NH2-terminal pro-B-type natriuretic peptide (NT pro-BNP), plasma aldosterone concentration, plasma renin activity, kidney function (urinary microalbumin, glomerular filtration rate), blood volume, and estimated pulmonary artery systolic pressure (ePASP) in Andean males without ( n = 14; age = 39 ± 11 yr) and with ( n = 10; age = 40 ± 12 yr) CMS at 4,330 m (Cerro de Pasco, Peru). Plasma renin activity (non-CMS: 15.8 ± 7.9 ng/mL vs. CMS: 8.7 ± 5.4 ng/mL; P = 0.025) and plasma aldosterone concentration (non-CMS: 77.5 ± 35.5 pg/mL vs. CMS: 54.2 ± 28.9 pg/mL; P = 0.018) were lower in highlanders with CMS compared with non-CMS, whereas NT pro-BNP was not different between groups (non-CMS: 1394.9 ± 214.3 pg/mL vs. CMS: 1451.1 ± 327.8 pg/mL; P = 0.15). Highlanders had similar total blood volume (non-CMS: 90 ± 15 mL·kg−1vs. CMS: 103 ± 18 mL·kg−1; P = 0.071), but Andeans with CMS had greater total red blood cell volume (non-CMS: 46 ± 10 mL·kg−1vs. CMS: 66 ± 14 mL·kg−1; P < 0.01) and smaller plasma volume (non-CMS: 43 ± 7 mL·kg−1vs. CMS: 35 ± 5 mL·kg−1; P = 0.03) compared with non-CMS. There were no differences in ePASP between groups (non-CMS: 32 ± 9 mmHg vs. CMS: 31 ± 8 mmHg; P = 0.6). A negative correlation was found between plasma renin activity and glomerular filtration rate in both groups (group: r = −0.66; P < 0.01; non-CMS: r = −0.60; P = 0.022; CMS: r = −0.63; P = 0.049). A smaller plasma volume in Andeans with CMS may indicate an additional CMS maladaptation to high altitude, causing potentially greater polycythemia and clinical symptoms. |
| Databáze: | OpenAIRE |
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