engleski

Tachycardia is associated with proximal tubule damage

OBJECTIVE: Even mild renal impairment is associated with increased central sympathetic activity. On the other hand, increased sympathetic activity could contribute to development of subclinical renal damage. Our aim was to analyse influence of tachycardia on metabolic disturbances and renal function in normotensives, prehypertensives and untreated hypertensives. DESIGN AND METHODS: In this analysis we have enrolled 933 subjects from the Croatian rural study. Blood pressure (BP) and heart rate (HR) were measured following ESH guidelines. Fasting blood was drawn for glucose (FBG), insulin, lipids, serum creatinine, CRP, white blood cell count and haematocrit determination. Waist circumference was measured. HOMA index, eGFR and BMI were calculated. Alpha1 microglobin (alpha1CR) and albumin to creatinine ratio (ACR) were determined. Based on HR subjects were divided quartiles (1st <72 bpm and 4th >85 bpm) within the three BP categories: normtoensives (<130/85) (N=224), prehypertensives (130- 139/85-89) (N=73) and hypertensives (>=140/90) (N=168). RESULTS: Comparing 2 HR groups (1st and 4th quartile) within the normotensives, significantly higher values of BMI, WC, FBG, alpha1CR, total cholesterol, LDL-C, triglycerides, insulin and HOMA, and significantly lower value of eGFR were found in the higher HR group (p<0.05). In prehypertensives significant differences were found in BMI, WC, FBG, total cholesterol, LDL- C, HOMA and alpha1CR and eGFR between the two HR groups. Finally, in hypertensives we have observed significantly higher values of age, BMI, WC, FBG, ACR, alpha1CR, total cholesterol, LDL-C, triglycerides, CRP and lower eGFR in the group with higher HR. CONCLUSION: Tachycardia is associated with visceral obesity, insulin resistance, inflammation and dyslipidemia decreased eGFR in all blood pressure groups. Interestingly, we found that tachycardia is associated with proximal tubule damage (alpha1CR) starting even from normal BP category. ACR was found to be increased only in HT subjects with tachycardia. Our results might suggest that in tachycardic subjects proximal tubule damage can be an early sign of kidney impairment, even preceding development of albuminuria.

Tachycardia ; proximal tubule damage

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