engleski

Renal function in prehypertension.

Introduction and Aims:Our aim was to analyse kidney function in prehypertensives comparing to subjects with optimal blood pressure and patients with untreated stage 1 hypertension. Methods:Out of 2489 subjects enrolled in Croatian rural study, 693 were eligible for further analysis. Exclusion criteria were antihypertensive treatment, hipertension stage 2, 3 and isolated systolic hypertension, diabetes mellitus, pregnancy, chronic terminal diseases, dementia, immobility and missing data. Blood pressure (BP) was measured following the ESH guidelines. Antropomietric measurements (height, weight) were determined. Fasting blood was analysed for serum creatinine. Urine was analysed for alpha1microglobulin, albumin, creatinine, sodium and potassium. Abbreviated MDRD formula was used to estimate glomerular filtration rate (eGFR). Albumin to creatinine ratio (ACR), alpha1 microglobin to creatinine ratio (alpha1CR) and sodium to potassium ratio (S/P ratio) were determined. Renal ultrasound was performed assesing longitudinal and transversal diameters and parenchimal thickness. Subjects were divided in three groups: optimal BP (<=120/80 ; N=316), prehypertensives (130/85- 139/89 ; N=210), and untreated hypertensives stage 1 (140-159/90-99 ; N=167). Results:Significant differences were found between the three groups in alpha1CR and eGFR (p=0.001 ; p<0.012, respectively). Optimal BP group showed to have significantly lower alpha1CR values than prehypertensives and hypertensives (4.2 vs. 4.7 vs. 5.3, p=0.001), as well as serum creatinine (79 vs. 83 vs. 83, p=0.0001) ; while differed significantly only from hypertensives in eGFR (82.1 vs. 80.1 vs. 77.8, p=0.0122). No differences between prehypertensives and hypertensives were observed either in those parameters or kidney size determined by ultrasound, urine potassium and urine sodium, and ACR, although a trend of increment in ACR related to BP was observed (4.0 vs. 4.5 vs. 4.6). Conclusions:No differences were found in markers of kidney function between prehypertensives and untreated hypertensives stage 1. As we have already reported higher values of alpha1microglobulin excretion observed in prehypertension might point on early proximal tubule damage present in high normal BP stage.

Kidney-function; prehypertension

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