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首页> 外文期刊>American Journal of Hypertension >Serum uric Acid levels and renal damage in hyperuricemic hypertensive patients treated with Renin-Angiotensin system blockers.
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Serum uric Acid levels and renal damage in hyperuricemic hypertensive patients treated with Renin-Angiotensin system blockers.

机译：肾素-血管紧张素系统阻滞剂治疗的高尿酸血症高血压患者的血清尿酸水平和肾脏损害。

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摘要

BACKGROUND: A correlation between hyperuricemia and renal target organ damage (TOD) was shown in hypertensive patients, locally mediated by the activation of renin-angiotensin system (RAS). We investigated whether high serum uric acid (UA) levels could negatively affect tubulointerstitial damage in hyperuricemic essential hypertensive patients with normal renal function, on treatment with RAS-blocking drugs. METHODS: We studied 40 patients with World Health Organization stage I-II essential hypertension, 9 with high serum UA levels (hyperuricemic group) and 31 with normal serum UA levels (normouricemic group, either normouricemics, n = 15, or formerly hyperuricemics in chronic allopurinol treatment, n = 16). All patients were on RAS-blocking drugs (either angiotensin-converting enzyme inhibitors or angiotensin II receptors blockers). Evaluation of renal TOD included urinary albumin excretion (UAE), Doppler ultrasound renal resistive index (RRI) and renal volume-to-resistive index ratio (RV/RRI) measurements. RESULTS: Hyperuricemics had significantly higher RRI and lower RV/RRI values than normouricemics. Creatinine clearance and UAE were similar between groups. Linear regression analysis showed that RV/RRI values were inversely related to serum UA levels (r = -0.57, P < 0.01). The logistic regression analysis selected serum UA as an independent predictor of decreased RV/RRI (odds ratio 4.45, 95% CI 1.47-13.45, P = 0.01). CONCLUSIONS: In hyperuricemic hypertensives normal serum UA levels are associated with normal RV/RRI, integrated marker of tubulointerstitial damage and renal arteriolopathy, independently of RAS activation.
机译：背景：在高血压患者中，高尿酸血症和肾靶器官损害（TOD）之间存在相关性，这是由肾素-血管紧张素系统（RAS）的激活局部介导的。我们调查了高血清尿酸（UA）水平是否对使用RAS阻断药物治疗的肾功能正常的高尿酸血症性原发性高血压患者的肾小管间质损害产生负面影响。方法：我们研究了40例世界卫生组织I-II期原发性高血压，9例血清UA水平高的患者（高尿酸血症组）和31例血清UA水平正常的患者（正常尿酸组，正常尿酸组，n = 15，或以前曾在慢性尿毒症中使用高尿酸组别嘌醇治疗，n = 16）。所有患者均使用RAS阻断药（血管紧张素转换酶抑制剂或血管紧张素II受体阻滞剂）。肾脏TOD的评估包括尿白蛋白排泄（UAE），多普勒超声肾电阻指数（RRI）和肾体积电阻指数比（RV / RRI）测量。结果：高尿酸药比正常尿酸药具有更高的RRI和更低的RV / RRI值。两组之间的肌酐清除率和阿联酋相似。线性回归分析显示RV / RRI值与血清UA水平呈负相关（r = -0.57，P <0.01）。逻辑回归分析选择血清UA作为RV / RRI降低的独立预测因子（赔率比4.45，95％CI 1.47-13.45，P = 0.01）。结论：在高尿酸血症性高血压中，正常的血清UA水平与正常的RV / RRI，肾小管间质损害和肾小动脉病变的综合标志物相关，而与RAS激活无关。

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