Influence of atherosclerosis on age-related changes in renal size and function
Influence of atherosclerosis on age-related changes in renal size and function
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DOI：
10.1046/j.1365-2362.2003.01091.x
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发表时间：
2003-01-01
影响因子：
5.5
通讯作者：
Mali, WPTM
中科院分区：
文献类型：
--
作者：
Bax, L;van der Graaf, Y;Mali, WPTM
肾脏的大小和功能反映了肾脏的健康状况。这些参数与年龄、性别和体重相关。肾脏也受到微血管和大血管疾病的影响。方法对1056例参加SMART研究的老年人的资料进行分析，探讨动脉粥样硬化对年龄与肾脏大小和功能的关系，以及动脉粥样硬化对肾脏大小和功能的影响。对新近转诊至医院的有血管疾病表现的患者进行无创性动脉粥样硬化筛查。颈动脉内膜中层厚度（IMT）和蛋白尿被用作动脉粥样硬化负荷的估计。肾脏大小定义为超声测量的双肾平均极间长度。结果肾内-中膜厚度是年龄-肾脏大小关系的重要影响因素（P = 0.041）。IMT最高三分位组血清肌酐随年龄的增加更为明显（P = 0.048）。在有和没有高血压或糖尿病（DM）的患者中，肾脏大小随着年龄的增长而同样减小。年龄与肾功能的关系也是如此。结论随着年龄的增长，动脉粥样硬化可加速肾脏体积的减小和血肌酐的升高。肾的大小和功能由蛋白尿和糖尿病决定。
Background Renal size and function reflect the health of the kidney. These parameters are associated with age, gender and body weight. The kidneys are also influenced by micro- and macrovascular diseases. Atherosclerotic markers and risk factors may influence the age-related changes of renal size and function.Methods Data of 1056 patients who entered the SMART-study (Second Manifestations of ARTerial disease) were used to assess the effect of atherosclerosis on the relationship between age and renal size and function and to study the effect of atherosclerosis on renal size and function. Patients who were newly referred to the hospital with manifestations of vascular disease were screened for asymptornatic atherosclerosis with noninvasive tests. The carotid intima-media thickness (IMT) and albuminuria were used as estimates for the atherosclerotic burden. Renal size was defined as the mean pole-to-pole length of both kidneys measured by ultrasonography. Renal function was represented by serum creatinine.Results Intima-media thickness was a significant effect modifier of the age-renal size relationship (P = 0.041). The increase of serum creatinine with age was more pronounced in the highest tertile of IMT (P = 0.048). Renal size decreased equally with age in patients with and without hypertension or diabetes mellitus (DM). The same held true for the age-renal function relationship. Albuminuria and DM were independent predictors of renal size and function.Conclusion Atherosclerosis accelerates the decrease of renal size and the increase of serum creatinine with age. Renal size and function are determined by albuminuria and DM.