Higher prevalence of unrecognized kidney disease at high altitude
Higher prevalence of unrecognized kidney disease at high altitude
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DOI：
10.1007/s40620-017-0456-0
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发表时间：
2018-04-01
影响因子：
3.4
通讯作者：
Pando, Jackelina
中科院分区：
文献类型：
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作者：
Hurtado-Arestegui, Abdias;Plata-Cornejo, Raul;Pando, Jackelina
背景高海拔肾综合征已在红细胞过多的人群中被描述。方法对无高血压、糖尿病或慢性肾脏疾病病史的高海拔地区健康受试者的肾功能和代谢综合征的患病率进行横断面研究。结果共调查293名40~60岁的受试者，其中高海拔地区125人(154 M)，高海拔地区168人(3640 M)。与SL患者相比，HA患者有更高的血肌酐，更低的估计肾小球功能比率(102.1+/-17.8ml/min/1.73m(2)，p<；0.0001)，更多的蛋白尿和更高的血红蛋白浓度。HA受试者的代谢综合征患病率较低。在女性(p=0.001)和男性(p=0.03)HA居住者中，血红蛋白浓度与表皮生长因子受体呈负相关。用Logistic回归分析比较90ml/min/1.73m(2)和90ml/min/1.73m(2)的受试者，女性(调整后的优势比：5.65[95%可信区间：2.43-13.13]；p=0.001)、海拔高度(14.78[6.46-33.79]；p=0.001)、血红蛋白(1.68[1.16-2.43]；p=0.001)和尿酸(1.93[1.36-2.72]；P=0.001)。结论与居住在SL地区的人相比，被认为健康的高海拔地区居民肾功能较差，蛋白尿的患病率较高，代谢综合征的患病率较低。
Background High altitude renal syndrome has been described in populations with excessive erythrocytosis. We evaluated whether high altitude (HA) dwellers might be at increased risk for kidney disease.Methods We performed a cross-sectional study to investigate differences in prevalence of kidney function and metabolic syndrome in healthy subjects living at HA vs. sea level (SL) without any known history of hypertension, diabetes or chronic kidney disease.Results We examined 293 subjects, aged 40 to 60 years: 125 SL (154 m) and 168 HA (3640 m) dwellers. HA dwellers had higher serum creatinine, lower estimated glomerular function rate (eGFR) (69.5 +/- 15.2 vs. 102.1 +/- 17.8 ml/min/1.73 m(2), p < 0.0001), more proteinuria and higher hemoglobin concentrations compared to SL subjects. HA subjects had a lower prevalence of metabolic syndrome. Hemoglobin concentrations correlated inversely with eGFR in female (p = 0.001) and male (p = 0.03) HA dwellers. Using logistic regression analysis to compare subjects with eGFR < 90 vs. > 90 ml/min/1.73 m(2), a lower eGFR was associated with female gender (odds ratio adjusted: 5.65 [95% confidence interval: 2.43-13.13]; p = 0.001), high altitude (14.78 [6.46-33.79]; p = 0.001), hemoglobin (1.68 [1.16-2.43]; p = 0.001) and uric acid (1.93 [1.36-2.72]; p = 0.001).Conclusions Dwellers at high altitude who are considered healthy have worse kidney function, a higher prevalence of proteinuria and a lower prevalence of metabolic syndrome compared to people living at SL.