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Microalbuminuria, endothelial dysfunction and inflammation in primary hypertension
Francesco Perticone1, Raffaele Maio, Giovanni Tripepi
1Internal Medicine and Cardiovascular Diseases Unit, Department of Experimental and Clinical Medicine G. Salvatore, University Magna Graecia of Catanzaro, Catanzaro - Italy.
Journal of Nephrology
|January 26, 2008
Summary
Microalbuminuria in hypertension is linked to kidney function decline, independent of inflammation and systemic endothelial dysfunction. This suggests microalbuminuria reflects local kidney endothelial issues contributing to renal impairment.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Hypertension Research
Background:
- Microalbuminuria, high-sensitivity C-reactive protein (CRP), and acetylcholine (ACh) response are indicators of endothelial dysfunction and inflammation.
- Essential hypertension is associated with increased risk of renal insufficiency.
- Understanding the interplay of these factors is crucial for managing hypertensive kidney disease.
Purpose of the Study:
- To investigate the relationship between microalbuminuria, inflammation (CRP), and endothelial function (ACh response) in never-treated essential hypertension.
- To determine the independent association of these factors with serum creatinine levels.
Main Methods:
- Study included 110 never-treated essential hypertension subjects with normal serum creatinine.
- Assessed microalbuminuria, serum CRP, and forearm hemodynamic response to ACh.
- Utilized univariate and multivariate regression analyses, including Framingham risk factors, to assess associations with serum creatinine.
Main Results:
- Microalbuminuria correlated with ACh response and serum creatinine.
- Microalbuminuria was largely independent of serum CRP.
- In multivariate analysis, microalbuminuria and CRP remained associated with serum creatinine, while ACh response lost predictive value.
Conclusions:
- Microalbuminuria in essential hypertension is weakly linked to systemic endothelial function (ACh response) and unrelated to inflammation (CRP).
- Microalbuminuria maintains an independent association with serum creatinine, suggesting a role in local renal endothelial dysfunction.
- These findings indicate microalbuminuria may contribute to renal impairment in hypertensive patients independently of inflammation and systemic endothelial dysfunction.
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