Early Sympathetic Activation in the Initial Clinical Stages of Chronic Renal Failure
Early Sympathetic Activation in the Initial Clinical Stages of Chronic Renal Failure
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DOI：
10.1161/hypertensionaha.110.164780
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发表时间：
2011-04-01
期刊：
影响因子：
8.3
通讯作者：
Mancia, Giuseppe
中科院分区：
文献类型：
--
作者：
Grassi, Guido;Quarti-Trevano, Fosca;Mancia, Giuseppe
神经肾上腺素能功能的直接和间接指标表明，终末期肾病的特征是明显的交感神经过度兴奋。然而，尚不清楚这种现象是否代表终末期肾病的特殊特征，或者是否也可以在疾病的早期临床阶段检测到。该研究在 73 名高血压患者中进行，其中 42 名（年龄：60.7 +/- 1.8 岁，平均 +/- SEM）患有稳定的中度慢性肾功能衰竭（平均估计肾小球滤过率：40.7 mL/min 每 1.73 m(2)，MDRD 公式）和 31 名年龄匹配的对照组，肾功能保留。测量包括人体测量变量、血压和逐搏血压、心率 (ECG)、静脉血浆去甲肾上腺素（高效液相色谱法）和传出节后肌肉交感神经活动（显微神经造影、腓神经）。对于相似的人体测量和血流动力学值，肾衰竭患者的肌肉交感神经活动值明显高于对照组（每 100 次心跳 60.0 +/- 2.1 与 45.7 +/- 2.0 爆发；P
Direct and indirect indices of neuroadrenergic function have shown that end-stage renal disease is characterized by a marked sympathetic overdrive. It is unknown, however, whether this phenomenon represents a peculiar feature of end-stage renal disease or whether it is also detectable in the early clinical phases of the disease. The study has been performed in 73 hypertensive patients, of which there were 42 (age: 60.7 +/- 1.8 years, mean +/- SEM) with a stable moderate chronic renal failure (mean estimated glomerular filtration rate: 40.7 mL/min per 1.73 m(2), MDRD formula) and 31 age-matched controls with a preserved renal function. Measurements included anthropometric variables, sphygmomanometric and beat-to-beat blood pressure, heart rate (ECG), venous plasma norepinephrine (high-performance liquid chromatography), and efferent postganglionic muscle sympathetic nerve activity (microneurography, peroneal nerve). For similar anthropometric and hemodynamic values, renal failure patients displayed muscle sympathetic nerve activity values significantly and markedly greater than controls (60.0 +/- 2.1 versus 45.7 +/- 2.0 bursts per 100 heartbeats; P