Albuminuria and Endothelial Dysfunction in Patients with Non-Diabetic Chronic Kidney Disease.

Albuminuria and Endothelial Dysfunction in Patients with Non-Diabetic Chronic Kidney Disease.
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DOI:
10.12659/msm.903660
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发表时间:
2017-09-15
期刊:
Medical science monitor : international medical journal of experimental and clinical research
影响因子:
--
通讯作者:
Chen XM
Chen XM
中科院分区:
其他
文献类型:
--
作者:
Huang MJ;Wei RB;Zhao J;Su TY;Li QP;Yang X;Chen XM

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蛋白尿与心血管事件有关,但这种关联是否可以用内皮功能障碍来解释尚不完全清楚。在这项研究中,我们研究了慢性肾脏病(CKD)患者的尿白蛋白肌酐比(UACR)与内皮功能生物标志物之间的关系。对 151 名连续 CKD(3-5 期)患者的肾功能障碍和 UACR 与促凝血和炎症因子的横断面关联进行了评估。受试者根据 UACR(≤300 mg/g 或 >300 mg/g)和估计肾小球滤过率 (eGFR)(30≤ eGFR <60、15≤ eGFR <30 或 eGFR <15 ml/min/1.73 m2)进行分组。较高的 UACR 水平与血管性血友病因子抗原 (vWF: Ag) 水平、vWF 活性、因子 VIII、白细胞介素 2 和 log (白细胞介素 6) 的增加相关,即使在调整危险因素后也是如此。线性回归分析表明,UACR 每增加 88.5 mg/g,vWF 活性和因子 VIII 分别升高 8.3% 和 6.3%。析因设计方差分析数据显示,UACR 和 CKD 分期与促凝血和炎症因子之间没有统计学上显着的相互作用。我们的研究表明,在 CKD 患者中,较高的 UACR 与内皮功能障碍和炎症因子标志物的升高存在独立的 eGFR 相关性。
Albuminuria has been associated with cardiovascular events, but whether such an association can be explained by endothelial dysfunction is not fully understood. In this study, we examined the relationship between the urine albumin-to-creatinine ratio (UACR) and biomarkers of endothelial function in patients with chronic kidney disease (CKD). The cross-sectional associations of renal dysfunction and UACR with procoagulant and inflammatory factors were evaluated for 151 consecutive CKD (stage 3–5) patients. Subjects were grouped by UACR (≤300 mg/g or >300 mg/g) and estimated glomerular filtration rate (eGFR) (30≤ eGFR <60, 15≤ eGFR <30, or eGFR <15 ml/min per 1.73 m2). A higher UACR level was associated with an increase in von Willebrand factor antigen (vWF: Ag) levels, vWF activity, factor VIII, interleukin-2, and log (interleukin-6), even after adjustment for risk factors. Linear regression analysis indicated that for every 88.5 mg/g increase in UACR, the vWF activity and factor VIII were elevated by 8.3% and 6.3%, respectively. The factorial design ANOVA data showed no statistically significant interaction between UACR and CKD stage with procoagulant and inflammatory factors. Our study shows an eGFR-independent association of higher UACR with elevations in markers of endothelial dysfunction and inflammatory factors in CKD patients.
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