Estimated plasma osmolarity and risk of end-stage kidney disease in patients with IgA nephropathy
Estimated plasma osmolarity and risk of end-stage kidney disease in patients with IgA nephropathy
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IgA 肾病患者的估计血浆渗透压和终末期肾病风险
DOI：
10.1007/s10157-020-01919-3
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发表时间：
2020
影响因子：
2.3
通讯作者：
Kitazono Takanari
中科院分区：
文献类型：
--
作者：
Tanaka Shigeru;Nakano Toshiaki;Tokumoto Masanori;Masutani Kosuke;Tsuchimoto Akihiro;Ooboshi Hiroaki;Kitazono Takanari
背景一些实验研究表明，反复脱水引起的血浆渗透压升高通过加压素分泌和醛糖还原酶途径激活介导的机制参与肾损伤。在原发性肾小球肾炎患者中，缺乏将血浆渗透压升高与终末期肾病（ESKD）发病联系起来的流行病学证据。MethodsWe回顾性检查了663例经肾活检诊断的伊加肾病（IgAN）患者，并使用考克斯比例风险模型评估了血浆渗透压估计值与ESKD患病率之间的相关性。（中位数80.4个月;四分位数间距22.2-120.1），73例患者发生ESKD。在基线调查中，血浆渗透压与估计的肾小球滤过率的平均值呈负相关，但与尿蛋白排泄的平均值、收缩压、毛细血管外增生的病理严重程度以及组织纤维化和硬化呈正相关。ESKD的发生率随血浆渗透压的增加而线性增加（趋势P< 0.05）。在多变量分析中，血浆渗透压是一个独立的危险因素ESKD（危险比为每增加5 mOsm/kg的血浆渗透压1.56; 95%置信区间1.18-2.07），即使调整后的潜在confronters.ConclusionsIncreased血浆渗透压与ESKD在IgA肾病患者的风险增加显着相关。通过适当控制盐和水之间的平衡来维持血浆渗透压可能有助于肾脏保护。
BackgroundSeveral experimental studies have indicated that increased plasma osmolarity caused by recurrent dehydration is involved in kidney injury via a mechanism, mediated by vasopressin secretion and activation of the aldose reductase pathway. Epidemiologic evidence linking increased plasma osmolarity and the onset of end-stage kidney disease (ESKD), in patients with primary glomerulonephritis, is lacking.MethodsWe retrospectively examined 663 patients with IgA nephropathy (IgAN) diagnosed by kidney biopsy and evaluated the association between estimated plasma osmolarity and ESKD prevalence, using a Cox proportional hazards model.ResultsDuring follow-up (median 80.4 months; interquartile range 22.2–120.1), 73 patients developed ESKD. In a baseline survey, plasma osmolarity was correlated negatively with the mean value of the estimated glomerular filtration rate, but correlated positively with the mean value of urinary protein excretion, systolic blood pressure, and pathologic severity of extracapillary proliferation, in addition to tissue fibrosis and sclerosis. The incidence rate of ESKD increased linearly with increase in plasma osmolarity (P< 0.05 for trend). In multivariate analyses, plasma osmolarity was an independent risk factor for ESKD (hazard ratio for each increment of 5 mOsm/kg in plasma osmolarity 1.56; 95% confidence interval 1.18–2.07) even after adjustment for potential confounders.ConclusionsIncreased plasma osmolarity was associated significantly with an increased risk of ESKD in patients with IgAN. Maintenance of plasma osmolarity by appropriate control of the balance between salt and water may contribute to kidney protection.
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影响因子：
2.3
作者：
Yamamoto, Yoshihiro;Hiki, Yoshiyuki;Nakai, Shigeru;Yamamoto, Koichiro;Takahashi, Kazuo;Koide, Shigehisa;Murakami, Kazutaka;Tomita, Makoto;Hasegawa, Midori;Kawashima, Shiro;Sugiyama, Satoshi;Yuzawa, Yukio
通讯作者：
Yuzawa, Yukio
DOI：
10.2215/cjn.13841215
发表时间：
2016-08-01
影响因子：
9.8
作者：
Glaser, Jason;Lemery, Jay;Johnson, Richard J.
通讯作者：
Johnson, Richard J.
影响因子：
2.1
作者：
Herrera, Raul;Orantes, Carlos M.;Aparicio, Claudia E.
通讯作者：
Aparicio, Claudia E.
影响因子：
6.1
作者：
Bardoux, P;Bichet, DG;Bankir, L
通讯作者：
Bankir, L
膳食盐通过 TGF-β1 增强肾小球内皮一氧化氮合酶。
DOI：
10.1152/ajprenal.1998.275.1.f18
发表时间：
1998
期刊：
The American journal of physiology
影响因子：
--
作者：
Ying,WZ;Sanders,PW
通讯作者：
Sanders,PW