Creatinine clearance, pulse wave velocity, carotid compliance and essential hypertension
Creatinine clearance, pulse wave velocity, carotid compliance and essential hypertension
复制标题
DOI：
10.1046/j.1523-1755.2001.0590051834.x
复制
发表时间：
2001-05-01
影响因子：
19.6
通讯作者：
Safar, ME
中科院分区：
文献类型：
--
作者：
Mourad, JJ;Pannier, B;Safar, ME
背景资料。终末期肾病患者的血管特征是动脉硬度增加，与血压无关。墙压力和心血管危险因素，如高血压、血糖和胆固醇、肥胖和烟草消费。血肌酐低于或等于130mU/L的受试者是否存在动脉僵硬和肾功能的统计学相关性尚未确定。对1290例血压正常或升高、血肌酐<130mU/L的受试者，按计算的内生肌酐清除量分为三组。同时测定血压、主动脉脉搏波速度(PWV)和标准心血管危险因素。对112例高血压病患者的颈总动脉和桡动脉的结构和功能(高分辨率回声多普勒技术)也进行了测量。在1290名受试者中，只有低三分位数组的PWV与肌酐清除率呈显著负相关，而不受血压和标准危险因素的影响。这种关联性在55岁或以下的受试者中更强。在112名高血压患者中，即使在对年龄、性别进行所有调整后，颈动脉顺应性与内生肌酐清除量仍呈正相关。还有血压。低于颈动脉顺应性变异的55%。没有观察到这样的结果反映了桡动脉的顺应性。在统计上，在轻到中度肾功能不全的受试者中，中央动脉僵硬的增加与肌酐清除量的降低有关，这表明肾脏的改变可能不仅与小动脉相互作用，也可能与大动脉相互作用，这与年龄、血压无关。和标准的风险因素。
Background. The vascular hallmark of subjects with endstage renal disease is increased arterial stiffness independent of blood pressure. wall stress, and cardiovascular risk factors such as hypertension, plasma glucose and cholesterol, obesity, and tobacco consumption. Whether arterial stiffness and kidney function ale statistically associated in subjects with plasma creatinine less than or equal to 130 mu mol/L has not yet been determined.Material. In 1290 subjects with normal or elevated blood pressure values and plasma creatinine less than or equal to 130 mu mol/L, subjects were divided into three tertiles according to the calculated creatinine clearance. Blood pressure aortic pulse wave velocity (PWV), and standard cardiovascular risk factors were determined in parallel. In 112 of the hypertensive subjects, common carotid and radial artery structure: and function (high-resolution echo-Doppler techniques) also were measured.Results. From the 1290 subjects, only the low-tertile group presented a significant negative association between PWV and creatinine clearance independently of blood pressure and standard risk factors. This association was stronger in subjects less than or equal to 55 years of age. In the 112 hypertensive subjects, carotid compliance was positivsly correlated to creatinine clearance even after all adjustment for age, gender. and blood pressure. At less than 55 of the variance of carotid compliance. Such findings were not observed for radial artery compliance.Conclusion. Increased stiffness of central arteries is statistically associated with reduced creatinine clearance in subjects With mild-to-moderate renal insufficiency, indicating that kidney alterations may interact not only with small but also large arteries, and this is independent of age, blood pressure. and standard risk factors.