The renal function in men with hypertension in conditions of purine and carbohydrate metabolism disorders

Authors

DOI:

https://doi.org/10.14739/2409-2932.2022.3.266580

Keywords:

arterial hypertension, kidney function, hyperuricemia, hyperglycemia, microalbuminuria

Abstract

Aim. To assess the condition of renal function in hypertensive men in conditions of disorders of purine and carbohydrate metabolism

Material and methods. 60 male patients (aged from 18 to 65 years) with stage I–II of arterial hypertension (AH) and purine and carbohydrate metabolism disorders were examined. In these patients, the level of uric acid (UA) in daily urine, fractional excretion of UA, creatinine in daily urine, microalbumin in urine and the cystatin C level were determined. Hemodynamics was studied by daily blood pressure monitoring. Assessment of kinetics and deformation of the myocardium in offline mode using the Xstrain software package integrated into the ultrasound device (Esaote, Italy) was made. Patients were divided into 2 clinical groups – 1 group of AH with hyperuricemia, 2 – AH without uricemia. Statistical analysis of the results was performed using the Statistica 13.0 software package (Statsoft, USA).

Results. Correlation analysis in group 1 showed a positive correlation of cystatin C with the average daytime systolic blood pressure (SBP) (r = 0.408) and the variability of diastolic blood pressure (DBP) at night (r = 0.405), urinary microalbumin with the average SBP at night (r = 0.390) and average pulse blood pressure (r = 0.402), LV posterior wall thickness (r = 0.438), LV myocardial mass index (r = 0.621), end-diastolic index (EDI) (r = 0.492), end-systolic index (ESI) (r = 0.426), LV anterior-posterior size (r = 0.385). A negative correlation was established between blood serum SC and ejection fraction (EF) of the LV (r = -0.410), urinary microalbumin with cardiac index (SI) (r = -0.555) and the speed of movement of the lateral (e’ lat) part of the annulus fibrosus mitral valve (r = -0.453).

Conclusions. As a result of the studies, the negative influence of hyperuricemia and hyperglycemia in patients with AH on renal function was established. These changes were evidenced by an increase in microalbuminuria level, a decrease in the fractional excretion of UA, an increasing the serum UA level, remodeling of the myocardium, and worsening of the heart systolic function, worsening of the daily blood pressure profile.

Author Biographies

O. V. Dudko, Zaporizhzhia State Medical University, Ukraine

PhD Student of the Department of Family Medicine, Therapy, Cardiology and Neurology

M. Yu. Kolesnyk, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor of the Department of Family Medicine, Therapy, Cardiology and Neurology of Faculty of Postgraduate Education

References

World Health Organization. https://www.who.int/ru

Drozdova I. V., Babets A. A., Stepanova L. H., Omelnytska L. V. (2017). Zakhvoriuvanist, poshyrenist ta invalidnist unaslidok hipertonichnoyi khvoroby: pidkhody do analizu y prohnozuvannia [Incidence, prevalence and disability due to hypertension: approaches to analysis and forecasting]. Ukrainskyi kardiolohichnyi zhurnal, (1), 85-93. [in Ukrainian].

NCD Risk Factor Collaboration (NCD-RisC) (2017). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet, 389(10064), 37-55. https://doi.org/10.1016/S0140-6736(16)31919-5

Khimion, L. V., Tymoshchuk, L. S., Rybitskaia, M. A., & Shadrin, A. B. (2018). Stratifikatsiya faktorov serdechno-sosudistogo riska i funktsionalnyi pochechnyi rezerv u bolnykh s essentsial'noi arterialnoi gipertenziei [Stratification of cardiovascular risk factors and functional renal reserve in patients with essential arterial hypertension]. Semeinaia meditsyna, (1), 77-80. [in Russian]. https://doi.org/10.30841/2307-5112.1.2018.135226

Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., Kahan, T., Mahfoud, F., Redon, J., Ruilope, L., Zanchetti, A., Kerins, M., Kjeldsen, S. E., Kreutz, R., Laurent, S., Lip, G., … Authors/Task Force Members: (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hyper-tension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European Heart Journal, 39(33), 3021-3104. https://doi.org/10.1093/eurheartj/ehy339

Levin, A., Stevens, P. E., Bilous, R. W., Coresh, J., De Francisco, A. L. M., De Jong, P. E., Griffith, K., Hemmelgarn, B., Iseki, K., Lamb, E., Levey, A., Riella, M., Shlipak, M., Wang, H., White, C., … Winearls, C. G. (2013). Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International Supplements, 3(1), 1-150. https://doi.org/10.1038/kisup.2012.733

Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., Michos, E. D., Miedema, M. D., Muñoz, D., Smith, S. C., Jr, Virani, S. S., Williams, K. A., Sr, Yeboah, J., & Ziaeian, B. (2019). 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 140(11), e596-e646. https://doi.org/10.1161/CIR.0000000000000678

Ku, E., Lee, B. J., Wei, J., & Weir, M. R. (2019). Hypertension in CKD: Core Curriculum 2019. American journal of kidney diseases, 74(1), 120-131. https://doi.org/10.1053/j.ajkd.2018.12.044

Kuwabara, M., Kanbay, M., & Hisatome, I. (2018). Uric Acid and Hypertension Because of Arterial Stiffness. Hypertension, 72(3), 582-584. https://doi.org/10.1161/HYPERTENSIONAHA.118.11496

Berzin, O. V., & Kondratiuk V. Ye. (2018). Kardiovaskuliarni zakhvoriuvannia pry podahri [Cardiovascular diseases with gout]. Ukrainskyi naukovo-molodizhnyi zhurnal, (3-4), 66-70. [in Ukrainian].

Holovach, I. Yu. (2020). Bezsymptomna hiperurykemiia: chy ne prokhodymo my povz problemu? [Asymptomatic hyperuricemia: are we missing the problem?]. Simeina medytsyna, (8), 21-27. [in Ukrainian].

Pan, A., Teng, G. G., Yuan, J. M., & Koh, W. P. (2016). Bidirectional Association between Diabetes and Gout: the Singapore Chinese Health Study. Scientific reports, 6, 25766. https://doi.org/10.1038/srep25766

Holovach, Y. Iu. (2016). Diabeticheskaia bolezn pochek: vozmozhnosti i znachenie glikemicheskogo kontrolya dlya renoprotektsii [Diabetic kidney disease: possibilities and significance of glycemic control for renoprotection]. Praktykuiuchyi likar, 16(5), 17-22. [in Russian].

Orlova, I. V., & Stanislavchuk, M. A. (2018). Porushennia purynovoho obminu u khvorykh na podahru: zviazok z dysadypokinemiieiu [Disorders of purine metabolism in patients with gout: relationship with dysadipokinemia]. ScienceRise: Medical Science, 23(3), 18-22. [in Ukrainian]. https://doi.org/10.15587/2519-4798.2018.127004

Korylchuk, N. I. (2019). Sposib zhyttia yak osnova metabolichnoho syndromu: pohliad na nashi realii [Lifestyle as the basis of the metabolic syndrome: a look at our realities]. Visnyk sotsialnoi hihiieny ta orhanizatsii okhorony zdorovia Ukrainy, (3), 114-123. [in Ukrainian]. https://doi.org/10.11603/1681-2786.2019.3.10586

Richette, P., Doherty, M., Pascual, E., Barskova, V., Becce, F., Castaneda, J., Coyfish, M., Guillo, S., Jansen, T., Janssens, H., Lioté, F., Mallen, C. D., Nuki, G., Perez-Ruiz, F., Pimentao, J., Punzi, L., Pywell, A., So, A. K., Tausche, A. K., Uhlig, T., … Bardin, T. (2020). 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. Annals of the rheumatic diseases, 79(1), 31-38. https://doi.org/10.1136/annrheumdis-2019-215315

Introduction: Standards of Medical Care in Diabetes-2020. (2020). Diabetes care, 43(Suppl 1), S1-S2. https://doi.org/10.2337/dc20-Sint

Dobrowolski, P., Januszewicz, A., Gumprecht, J., Małyszko, J., Narkiewicz, K., Stompór, T., Tykarski, A., Więcek, A., & Prejbisz, A. (2021). Why albuminuria should be assessed more frequently in everyday clinical practice? A position statement. Polish archives of internal medicine, 131(4), 396-406. https://doi.org/10.20452/pamw.15874

Chernyaeva, A. O., & Mykytyuk, M. R. (2021). Tsystatyn C yak marker nyrkovoi funktsii u khvorykh na tsukrovyi diabet z porushenniamy purynovoho obminu [Cystatin C as a marker of renal function in diabetic patients with disorders of purine metabolism]. Aktualni problemy suchasnoi medytsyny: Visnyk Ukrainskoi medychnoi stomatolohichnoi akademii, 21(2), 87-92. [in Ukrainian]. https://doi.org/10.31718/2077-1096.21.2.87

Zhang, X., & Lerman, L. O. (2017). The Metabolic Syndrome and Chronic Kidney Disease. Translational Research. Mosby Inc. https://doi.org/10.1016/j.trsl.2016.12.004

Buzas, R., Tautu, O. F., Dorobantu, M., Ivan, V., & Lighezan, D. (2018). Serum uric acid and arterial hypertension—data from sephar III survey. PLoS ONE, 13(7). https://doi.org/10.1371/journal.pone.0199865

Xie, N., Li, X., Zhong, Q., Zhou, D., Cai, A., Zhang, Y., Zhou, Y., & Feng, Y. (2019). Association of systolic blood pressure and pulse pressure with microalbuminuria in treatment-naïve hypertensive patients. Archives of medical science : AMS, 15(4), 832-836. https://doi.org/10.5114/aoms.2018.77727

Bajaj, N. S., Singh, A., Zhou, W., Gupta, A., Fujikura, K., Byrne, C., Harms, H. J., Osborne, M. T., Bravo, P., Andrikopolou, E., Divakaran, S., Bibbo, C. F., Hainer, J., Skali, H., Taqueti, V., Steigner, M., Dorbala, S., Charytan, D. M., Prabhu, S. D., Blankstein, R., … Di Carli, M. F. (2020). Coronary Microvascular Dysfunction, Left Ventricular Remodeling, and Clinical Outcomes in Patients With Chronic Kidney Impairment. Circulation, 141(1), 21-33. https://doi.org/10.1161/CIRCULATIONAHA.119.043916

Khimion, L. V., & Tymoshchuk, L. S. (2017). Vplyv variabelnosti arterialnoho tysku na funktsionalnyi nyrkovyi rezerv pry esentsialnii arterialnii hipertenzii I stadia [The effect of blood pressure variability on the functional renal reserve in stage I essential arterial hypertension]. Siemieinaia meditsina, (1), 72-79. [in Ukrainian].

Published

2022-11-15

How to Cite

1.
Dudko OV, Kolesnyk MY. The renal function in men with hypertension in conditions of purine and carbohydrate metabolism disorders. Current issues in pharmacy and medicine: science and practice [Internet]. 2022Nov.15 [cited 2024Apr.26];15(3):313-8. Available from: http://pharmed.zsmu.edu.ua/article/view/266580

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Section

Original research