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Hypertension:在儿童慢性肾病队列中尿调素与血压无关

2022-08-25 MedSci原创 MedSci原创

在慢性肾病儿童队列中,尿液中尿调节素水平与血压无关,但需要在健康的儿科队列中进一步的研究证实这一研究结果。

在健康人群中,尿调素是尿液中含量最丰富的蛋白质,具有多种功能。此外,尿调素能够调节Henle环中钠钾二氯同向转运蛋白的转运活性。在成年人中,较高的尿调素水平与较高的血压有关,以应对盐的摄入。

近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员假设慢性肾病患儿尿调素水平升高也与血压升高有关系,并且饮食中摄入的钠在这一相关性上存在相互作用。

儿童慢性肾病队列中,研究人员利用单变量和多变量线性回归模型评估了基线尿液中尿调素水平(与尿肌酐相关的Umod/Crmg/g)与24小时平均收缩压和舒张压以及基线临床血压之间的关系。研究人员还评估了机体钠摄入量(g/day)是否会改变这些相关性。

在436名参与者中,他们的中位年龄为12.4岁(8.9-15.2),估计的肾小球滤过率中位数为50mL/min/1.73m2(36-62),24小时平均收缩压中位数为112mmHg(104-119)。慢性肾病的病因为肾小球疾病占27%。在单变量模型中,Umod/Cr比值每提高2倍,24小时平均收缩压降低1.66mmHg(95%CI为-2.31~-1.00),收缩压降低1.71mmHg(-2.45~-0.97)。然而,在多变量模型中,Umod/Cr与24小时或血压之间没有统计学上的显著相关性。研究人员没有发现尿调素水平和钠摄入量对血压的影响有显著的相互作用(所有模型中均有P>0.05)。

由此可见,在慢性肾病儿童队列中,尿液中尿调节素水平与血压无关,但需要在健康的儿科队列中进一步的研究证实这一研究结果。

原始出处:

Christine Y. Bakhoum.et al.Urine Uromodulin Is Not Associated With Blood Pressure in the Chronic Kidney Disease in Children Cohort.Hypertension.2022.https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.122.19566

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