Microalbuminuria Fractional Clearance and Early Renal Permselectivity Changes in Essential Hypertension

Cottone, Santina; Cerasola, Giovanni

doi:10.1159/000168467

Cited by 12 publications

(2 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 -22 Albuminuria may therefore occur as a result of direct transmission of raised systemic pressure to the glomerulus 23,24 and/or permselectivity changes of the glomerular filter. 25 Blood pressure is already known to relate to albuminuria in the population, 8 a fact that we confirmed in the present study. A new finding of our study shows that the relation was more pronounced in subjects with an elevated CRP level.…”

Section: Discussionsupporting

confidence: 86%

C-Reactive Protein Modifies the Relationship Between Blood Pressure and Microalbuminuria

et al. 2004

View full text Add to dashboard Cite

Abstract-C-reactive protein (CRP) and microalbuminuria reflect intimately related components of the atherosclerotic disease process. Epidemiological studies found only modest associations between CRP and microalbuminuria. Blood pressure, one of the components of the metabolic syndrome in the general population, is the main determinant of microalbuminuria in diabetes and hypertension. We questioned whether CRP modifies the relationship of blood pressure and other cardiovascular risk factors with microalbuminuria in a cross-sectional study in 8592 inhabitants from Groningen, The Netherlands. The crude data showed an increase in the prevalence of microalbuminuria with increasing CRP quartiles (4.8, 9.6, 14. Key Words: cardiovascular diseases Ⅲ blood pressure Ⅲ risk factors Ⅲ kidney Ⅲ albuminuria C -reactive protein (CRP), a sensitive marker of (sub)clinical inflammation, is thought to represent the state of chronic low-grade inflammation of the arterial vessel wall at atherosclerotic sites. 1 CRP consistently predicts cardiovascular (CV) outcome. [2][3][4] Microalbuminuria is also an established risk marker for future cardiovascular events in various populations. 5,6 The appearance of low levels of albumin in the urine is thought to be the consequence of generalized endothelial damage along the vascular tree, including the glomerulus. 7 Blood pressure has been shown to be the main determinant of microalbuminuria in diabetes and hypertension. 8 Many other CV risk factors, which cluster within the metabolic syndrome, have been shown to relate to microalbuminuria in the population. 9,10 Because CRP and microalbuminuria reflect closely related components of the same disease processes, one might anticipate a strong relationship between them. However, studies that investigated this relationship in large populations only found weak associations. 11,12 Interdependence between CRP and other cardiovascular risk factors with the risk of microalbuminuria may have been overlooked.We questioned whether elevated serum CRP levels modify the relation of blood pressure and other CV risk factors with microalbuminuria. Methods Study DesignThis study is part of the PREVEND study (Prevention of REnal and Vascular ENdstage Disease) in Groningen, The Netherlands. PREVEND investigates the natural course of microalbuminuria in relation to renal and cardiovascular morbidity and mortality in the general population. All inhabitants aged 28 to 75 years (nϭ85 421) were asked to send in a morning urine sample and to complete a brief questionnaire on demographics and renal and cardiovascular morbidity. A total of 40 856 subjects responded. Pregnant women and subjects using insulin were excluded. All subjects with an albumin concentration of Ͼ10 mg/L in their morning urine sample plus a random sample of the population with a morning urine albumin excretion Ͻ10 mg/L were invited to our outpatient clinic. A detailed overview of this protocol is described elsewhere. 13 All subjects completed an extensive questionnaire on demographics, renal and cardio...

show abstract

Section: Discussionsupporting

confidence: 86%

C-Reactive Protein Modifies the Relationship Between Blood Pressure and Microalbuminuria

et al. 2004

View full text Add to dashboard Cite

show abstract

“…Hypertension may also cause progressive glomerulosclerosis. 20,21 In recent years, it has been postulated that growth factors may be involved in the pathophysiology of these structural derangements. 2,22,23 Several studies have shown that both platelet-derived and transforming growth factors, as well as TNF␣ may play a role in the pathogenesis of glomerular injury.…”

Section: Discussionmentioning

confidence: 99%

Comparison of tumour necrosis factor and endothelin-1 between essential and renal hypertensive patients

et al. 1998

View full text Add to dashboard Cite

The present study was performed to compare circulating levels of tumour necrosis factor-␣ (TNF␣) and plasma endothelin 1 (ET-1), of hypertensive patients with or without renal failure and with those of normotensive healthy subjects. The study population consisted of 21 healthy normotensive subjects and 22 hypertensive patients, 11 with essential hypertension, and 11 with hypertension and chronic renal failure (CRF).Plasma ET-1 levels, serum TNF␣ and creatinine, creatinine clearance, 24-h urinary albumin excretion (UAE) were assayed, and 24-h blood pressure monitoring was obtained in all subjects. Office blood pressure was similar between hypertensive patients with and without CRF. However, 24-h blood pressure was greater in patients with CRF than in those with essential hypertension and

show abstract

Subclinical Kidney Damage in Hypertensive Patients: A Renal Window Opened on the Cardiovascular System. Focus on Microalbuminuria

Mulè

Castiglia

Cusumano

et al. 2016

Advances in Experimental Medicine and Biology

View full text Add to dashboard Cite

The kidney is one of the major target organs of hypertension.Kidney damage represents a frequent event in the course of hypertension and arterial hypertension is one of the leading causes of end-stage renal disease (ESRD).ESRD has long been recognized as a strong predictor of cardiovascular (CV) morbidity and mortality. However, over the past 20 years a large and consistent body of evidence has been produced suggesting that CV risk progressively increases as the estimated glomerular filtration rate (eGFR) declines and is already significantly elevated even in the earliest stages of renal damage. Data was supported by the very large collaborative meta-analysis of the Chronic Kidney Disease Prognosis Consortium, which provided undisputable evidence that there is an inverse association between eGFR and CV risk. It is important to remember that in evaluating CV disease using renal parameters, GFR should be assessed simultaneously with albuminuria.Indeed, data from the same meta-analysis indicate that also increased urinary albumin levels or proteinuria carry an increased risk of all-cause and CV mortality. Thus, lower eGFR and higher urinary albumin values are not only predictors of progressive kidney failure, but also of all-cause and CV mortality, independent of each other and of traditional CV risk factors.Although subjects with ESRD are at the highest risk of CV diseases, there will likely be more events in subjects with mil-to-moderate renal dysfunction, because of its much higher prevalence.These findings are even more noteworthy when one considers that a mild reduction in renal function is very common in hypertensive patients.The current European Society of Hypertension (ESH)/European Society of Cardiology (ESC) guidelines for the management of arterial hypertension recommend to sought in every patient signs of subclinical (or asymptomatic) renal damage. This was defined by the detection of eGFR between 30 mL/min/1.73 m and 60 mL/min/1.73 m or the presence of microalbuminuria (MAU), that is an amount of albumin in the urine of 30-300 mg/day or an albumin/creatinine ratio, preferentially on morning spot urine, of 30-300 mg/g.There is clear evidence that urinary albumin excretion levels, even below the cut-off values used to define MAU, are associated with an increased risk of CV events. The relationships of MAU with a variety of risk factors, such as blood pressure, diabetes and metabolic syndrome and with several indices of subclinical organ damage, may contribute, at least in part, to explain the enhanced CV risk conferred by MAU. Nonetheless, several studies showed that the association between MAU and CV disease remains when all these risk factors are taken into account in multivariate analyses. Therefore, the exact pathophysiological mechanisms explaining the association between MAU and CV risk remain to be elucidated. The simple search for MAU and in general of subclinical renal involvement in hypertensive patients may enable the clinician to better assess absolute CV risk, and its identification may induc...

show abstract

Microalbuminuria Fractional Clearance and Early Renal Permselectivity Changes in Essential Hypertension

Cited by 12 publications

References 14 publications

C-Reactive Protein Modifies the Relationship Between Blood Pressure and Microalbuminuria

C-Reactive Protein Modifies the Relationship Between Blood Pressure and Microalbuminuria

Comparison of tumour necrosis factor and endothelin-1 between essential and renal hypertensive patients

Subclinical Kidney Damage in Hypertensive Patients: A Renal Window Opened on the Cardiovascular System. Focus on Microalbuminuria

Contact Info

Product

Resources

About