NDT:肾小球高滤过率随着糖尿病和高血压前期的增高而增加

2012-07-18 范振光 肾脏病与透析移植杂志

  该研究纳入了日本爱知县接受健康检查的99140名年龄20至89岁的对象。比较了各个时期糖尿病前期(FBS<100, 100–109, 110–125 and ≥126 mg/dl,分别表示无糖尿病前期,第1阶段糖尿病前期,第2阶段糖尿病前期和糖尿病)以及各个时期高血压前期(BP<120/80,120-129/80-84,130-139/85-89和≥140/90 mmHg,分别表示

  该研究纳入了日本爱知县接受健康检查的99140名年龄20至89岁的对象。比较了各个时期糖尿病前期(FBS<100, 100–109, 110–125 and ≥126 mg/dl,分别表示无糖尿病前期,第1阶段糖尿病前期,第2阶段糖尿病前期和糖尿病)以及各个时期高血压前期(BP<120/80,120-129/80-84,130-139/85-89和≥140/90 mmHg,分别表示无高血压前期,第1阶段高血压前期,第2阶段高血压前期和高血压病)肾小球高滤过(估计肾小球滤过率(eGFR)高于年龄/性别特殊化的第95百分位)和低滤过(eGFR低于年龄/性别特殊化的第95百分位)的发生率。随着糖尿病前期和高血压前期阶段的增高,高滤过率发生率增加【第1阶段糖尿病前期、第2阶段糖尿病前期、糖尿病的优势比(ORs)分别为:1.29、1.58、2.47;第1阶段高血压前期、第2阶段高血压前期、高血压病的ORs分别为:1.1.、1.33、1.52】。肾小球低滤过率与糖尿病前期及高血压前期均无关。随着糖尿病前期和高血压前期阶段的增高,高滤过率发生率增加。
 
  因此,对于糖尿病前期或高血压前期对象,应监测肾功能。已存在肾小球高滤过对象,早期治疗高血糖血症和高血压,对于防止肾脏损伤的进展可能是必要的。

   相关链接:Okada R,Yasuda Y,Tsushita K,Wakai K,Hamajima N,Matsuo S.Glomerular hyperfiltration in prediabetes and prehypertension.Nephrol Dial Transplant 2012 May;27(5):1821-5

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