Hyperphosphatemia and its relationship with blood pressure, vasoconstriction, and endothelial cell dysfunction in hypertensive hemodialysis patients.
Hyperphosphatemia and its relationship with blood pressure, vasoconstriction, and endothelial cell dysfunction in hypertensive hemodialysis patients.
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DOI：
10.1186/s12882-022-02918-0
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发表时间：
2022-08-23
期刊：
影响因子：
2.3
通讯作者：
Van Buren, Peter Noel
中科院分区：
文献类型：
--
作者：
Jung, Jinwoo;Jeon-Slaughter, Haekyung;Hang Nguyen;Patel, Jiten;Sambandam, Kamalanathan K.;Shastri, Shani;Van Buren, Peter Noel
高磷血症常发生在接受血液透析的终末期肾病患者中，并与死亡率增加相关。高磷血症有助于这些患者的血管钙化，但有新的证据表明，它也与内皮细胞功能障碍。我们在高血压血液透析患者中进行了一项横断面研究。我们获得了血液透析前总外周阻力指数（TPRI，无创心输出量监测仪）和血浆内皮素-1（ET-1）和不对称二甲基精氨酸（ADMA）水平的测量。我们确定了常规的透析期间血压（BP）测量从治疗和最近的血液透析前血清磷酸盐水平。我们使用广义线性回归分析来确定血磷与BP、TPRI、ET-1和ADMA之间的独立相关性，同时控制人口统计学变量、甲状旁腺激素（PTH）和透析间期体重增加。共分析了54例患者。HD前平均仰卧位和坐位收缩压和舒张压分别为164（27）、158（21）、91.5（17）和86.1（16）mmHg。平均血清磷酸盐为5.89（1.8）mg/dL。磷酸盐与所有血液透析前血压测量值之间存在显著相关性（r = 0.3，p = 0.04; r = 0.4，p = 0.002; r = 0.5，p <0.0001; r = 0.5，p = 0.0003）。磷酸盐与TPRI、ET-1和ADMA的相关性分别为0.3（p = .01）、0.4（p = .007）和0.3（p = .04）。在我们控制基线特征、PTH和透析间期体重增加的最终线性回归分析中，磷酸盐与血液透析前舒张压、TPRI和ET-1之间的独立相关性得以保留（β = 4.33，p = 0.0002;对数转换β = 0.05，p = 0.005;倒数转换β =-0.03，p = 0.047）。血磷浓度与HD前血压升高、血管收缩和内皮细胞功能障碍标志物独立相关。这些发现表明，除了血管钙化外，高磷血症对心血管健康还有其他负面影响。该研究是注册临床试验NCT 01862497（2013年5月24日）的一部分。
Hyperphosphatemia occurs frequently in end-stage renal disease patients on hemodialysis and is associated with increased mortality. Hyperphosphatemia contributes to vascular calcification in these patients, but there is emerging evidence that it is also associated with endothelial cell dysfunction. We conducted a cross-sectional study in hypertensive hemodialysis patients. We obtained pre-hemodialysis measurements of total peripheral resistance index (TPRI, non-invasive cardiac output monitor) and plasma levels of endothelin-1 (ET-1) and asymmetric dimethylarginine (ADMA). We ascertained the routine peridialytic blood pressure (BP) measurements from that treatment and the most recent pre-hemodialysis serum phosphate levels. We used generalized linear regression analyses to determine independent associations between serum phosphate with BP, TPRI, ET-1, and ADMA while controlling for demographic variables, parathyroid hormone (PTH), and interdialytic weight gain. There were 54 patients analyzed. Mean pre-HD supine and seated systolic and diastolic BP were 164 (27), 158 (21), 91.5 (17), and 86.1 (16) mmHg. Mean serum phosphate was 5.89 (1.8) mg/dL. There were significant correlations between phosphate with all pre-hemodialysis BP measurements (r = 0.3, p = .04; r = 0.4, p = .002; r = 0.5, p < .0001; and r = 0.5, p = .0003.) The correlations with phosphate and TPRI, ET-1, and ADMA were 0.3 (p = .01), 0.4 (p = .007), and 0.3 (p = .04). In our final linear regression analyses controlling for baseline characteristics, PTH, and interdialytic weight gain, independent associations between phosphate with pre-hemodialysis diastolic BP, TPRI, and ET-1 were retained (β = 4.33, p = .0002; log transformed β = 0.05, p = .005; reciprocal transformed β = -0.03, p = .047). Serum phosphate concentration is independently associated with higher pre-HD BP, vasoconstriction, and markers of endothelial cell dysfunction. These findings demonstrate an additional negative impact of hyperphosphatemia on cardiovascular health beyond vascular calcification. The study was part of a registered clinical trial, NCT01862497 (May 24, 2013).
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影响因子：
4.9
作者：
Bozic, Milica;Panizo, Sara;Valdivielso, Jose M.
通讯作者：
Valdivielso, Jose M.
影响因子：
13.6
作者：
Kestenbaum, B;Sampson, JN;Andress, DL
通讯作者：
Andress, DL
DOI：
10.2215/cjn.02610319
发表时间：
2019-11-07
影响因子：
9.8
作者：
Ginsberg, Charles;Houben, Alfons J. H. M.;Ix, Joachim H.
通讯作者：
Ix, Joachim H.
影响因子：
6
作者：
Kovesdy CP;Lu JL;Wall BM;Gyamlani G;Naseer A;Wallick A;Han Z;Thomas F;Quarles LD;Jarmukli N
通讯作者：
Jarmukli N
DOI：
10.1016/j.pbj.2017.02.005
发表时间：
2017-11-01
期刊：
Porto biomedical journal
影响因子：
--
作者：
Mendes, Margarida;Resende, Luis;Silva, Gil
通讯作者：
Silva, Gil