Renal Dysfunction in Patients with Resistant Hypertension: Association with Clinical Profile and Fat Depots

Автор: Popova A.A., Zyubanova I.V., Ryumshina N.I., Mordovin V.F., Lichikaki V.A., Manukyan M.A., Solonskaya E.I., Khunkhinova S.A., Skomkina I.A., Afanasiev S.A., Rebrova T.Yu., Gusakova A.M., Rudenko V.V., Falkovskaya A.Yu.

Журнал: Сибирский журнал клинической и экспериментальной медицины @cardiotomsk

Рубрика: Клинические исследования

Статья в выпуске: 1 т.40, 2025 года.

Бесплатный доступ

Introduction. Chronic kidney disease (CKD) and arterial hypertension (AH), especially its resistant forms, are two closely related and mutually aggravating diseases. The pathophysiology of CKD development in patients with resistant AH is complex and is not limited to the negative impact of hemodynamic, metabolic, neurohormonal and proinflammatory factors. The common pathophysiological mechanism of development of both diseases is visceral obesity, which has both systemic and local negative effects. However, aspects of kidney damage in patients with resistant AH (RAH) require further study, and their understanding may open up new possibilities in a comprehensive approach to nephroprotection.Aim: To study the relationship between a decrease in the functional state of the kidneys in patients with resistant hypertension and clinical data, the size of systemic and local fat depots, as well as markers of sympathetic activity.Material and Methods. Sixty-three patients with RAH were included in comparative cross-sectional study. CKD C3 was documented in 19 patients (30%). Magnetic resonance imaging (MRI) (1.5 Tesla) was used to assess the sizes of kidney and abdominal fat depots (thickness and area of subcutaneous and visceral adipose tissue (S SAT and VAT), paranephral adipose tissue thickness (PRAT). In addition to routine examinations, patients underwent measurement of cystatin C levels in the blood and 24-hour blood pressure monitoring. Activity of sympathetic nervous system was assessed by catecholamine’s measuring in urine and blood tests, beta-adrenergic membrane reactivity (β-ARM) of erythrocytes, and systolic BP variability.Results. Patients with CKD compared to patients without CKD were older, higher pulse BP levels (p = 0.005), fasting glucose (p = 0,007), had smaller kidney sizes (p = 0.046), S VAT (p = 0.025) and PRAT thickness (p = 0.013), and lower kidney diameter/PRAT ratio (p = 0.022). No intergroup differences were found in anthropometric indices, SAT thickness and markers of sympathetic activity. Decreased estimated glomerular filtration rate (eGFR) had quantitative associations with increased PRAT thickness and percent adipose tissue (AT) (r = -0.27, p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }

Еще

Chronic kidney disease, kidney dysfunction, hypertension, resistant hypertension, visceral fat, paranephral adipose tissue, anthropometric indices, sympathetic activation, beta-adrenergic reactivity, catecholamines

Короткий адрес: https://sciup.org/149147865

IDR: 149147865   |   DOI: 10.29001/2073-8552-2025-40-1-147-158

Статья научная