Renal function and nutritional status in patients with arterial hypertension

Authors

  • V.V. Rodionova SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine», Department of occupational diseases and clinical immunology, V. Vernadsky str., 9, Dnipro, 49044, Ukraine https://orcid.org/0000-0002-0221-5625
  • O.O. Boiko SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine», Department of occupational diseases and clinical immunology, V. Vernadsky str., 9, Dnipro, 49044, Ukraine https://orcid.org/0000-0003-0506-0486

DOI:

https://doi.org/10.26641/2307-0404.2020.4.221231

Keywords:

arterial hypertension, nutritional status, kidney function

Abstract

Arterial hypertension is the main preventable cause of cardiovascular disease and all causes of death worldwide, and also ranks second among the most important causes of chronic kidney disease after diabetes. An important factor contributing to the increase in blood pressure is obesity. Being overweight raises blood pressure and accounts for 65-75% of the initial hypertension, which is the main cause of cardiovascular disease and kidney disease. The aim of the work was to study renal function in patients with arterial hypertension, depending on the nutritional status of patients. Materials and methods. A prospective study included 47 stable outpatients with stage II arterial hypertension (left ventricular hypertrophy) of the 1st to 3rd degree, (24 women and 23 men), the average age was 55.7 (8.9) years. The mean disease duration was 14 (3.2) years. The control group included 28 relatively healthy people without arterial hypertension (15 women and 9 men), the average age was 56.0 (6.6) years. All patients were evaluated for complaints, medical history, smoking status, physical examination with anthropometric indicators (height, weight, body mass index, waist circumference), heart rate and blood pressure. The risk of cardiovascular events was also determined in accordance with the SCORE scale. The nutritional status was evaluated based on bioimpedancemetry data (Omron analyzer) with determination of the percentage of total fat, muscle mass and visceral fat. To determine the functional state of the kidneys, the level of total protein in blood serum, creatinine and albumin in the urine was determined, with the determination of the albumin creatinine ratio in a single portion of urine, the glomerular filtration rate were calculated. Results and conclusions. In patients with arterial hypertension, a change in nutritional status was detected in the form of an increase in the amount of total adipose tissue against a background of a decrease in muscle tissue pool, with the development of sarcopenia in combination with obesity. Also, patients developed hypertensive nephropathy. It was found that the BMI is not informative enough to determine nutritional status, but requires the use of bioimpedancemetry to determine the percentage of total  fat, visceral fat and muscle mass.

References

Antomonov MYu. [Mathematical processing and analysis of biomedical data]. MITC "Medinform". 2018;2:579. Russian.

Antoshchenko PA. [Features of change of the speed of club filtration in persons of an older age with physiological and pathological type of aging]. Inter­national Student Scientific Herald. 2016;6. Russian. Available from: https://www.eduherald.ru/pdf/2016/6/16662.pdf

Goropko OYu. [Obesity and hypertension: current views on pathogenesis, diagnosis and treatment]. Family medicine. 2019;2:1824. Russian. Available from: http://familymedicine.com.ua/article/view/174626

Lang TA, Sesik M. [How to describe statistics in medicine. Guide for authors, editors and reviewers. Practical Medicine]. 2011;47-49;65-77;93-95. Russian

Lopina EA. [Estimation of indicators of the kid­ney function in patients suffering with arterial hypertension and abdominal obesity, suffered from acute society under security]. Almanac of Clinical Medicine. 2016;44(3):301-7. Russian. doi: https://doi.org/10.18786/2072-0505-2016-44-3-301-307

Rodionova VV, Boyko OO, Turenko OA, Deni­senko OO. [Predictors of chronic heart failure develop­ment and progression in pre-dialysis patients with chronic kidney disease]. Kidneys. 2019;8(1):29-33. Ukrainian. doi: https://doi.org/10.22141/2307-1257.8.1.2019.157793

Satardinova EE, Olenskaya TL. [Relationship of the syndrome of malnutrice and sarcopenia in patients with arterial hypertension]. Modern problems of science and education. 2017;3. Russian. Available from: http://www.science-education.ru/ru/article/view?id=26354

Smirnov AV, Golubev RV, Korosteleva NY, Ru­myantsev AS. [Decline of physical performance in patients receiving renal replacement therapy: focus on sarcopenia]. Nephrology (Saint-Petersburg). 2017;21(4):9-29. Russian. doi: https://doi.org/10.24884/1561-6274-2017-21-4-9-29

Glinyanaya LA, Rodionova VV, Gashynova KY, et al. [Analysis of the activities of the city center of occu­pational diseases treatment on the basis of the Com­munal Enterprise "Dnipropetrovsk City Multiprofile Cli­nical Hos­pital N 4" DRC" and some aspects of the ex­perience of coo­peration with the Fund of Social In­surance against Industrial Accidents and Occupational Diseases of Ukraine in the city Dnepr]. Medicni perspectivi. 2017;3:40-47. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2018.3(part1).142335

Declèves AE, Sharma K. Obesity and kidney disease: differential effects of obesity on adipose tissue and kidney inflammation and fibrosis. Curr Opin Nephrol Hypertens. 2015 Jan;24(1):28-36. doi: https://doi.org/10.1097/MNH.0000000000000087. PMID: 25470014; PMCID: PMC4847436.

Hall JE, do Carmo JM, da Silva AA, et al. Obe­sity, kidney dysfunction and hypertension: mechanistic links. Nat. Rev. Nephrol. 2019;15:367-85 doi: https://doi.org/10.1038/s41581-019-0145-4

Apovian CM, et al. Pharmacological management of obesity: an endocrine society clinical practice gui­deline; 2015. doi: https://doi.org/10.1210/jc.2014-3415

Tian S, Xu Y. Association of sarcopenic obesity with the risk of all-cause mortality: a meta-analysis of prospective cohort studies. Geriatr Gerontol Int. 2016;169(2):155-66.

doi: https://doi.org/10.1186/s12877-019-1195-y

Williams B, Mancia G, Spiering W, Agabiti Rosei A, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. J Hypertens. 2018; 36:1953-2041. doi: https://doi.org/10.1097/HJH.0000000000001940

/ESH Guidelines for the management of arte­rial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardio­logy (ESC) and the European Society of Hypertension (ESH). European Heart Journal. 2018;39(33):3004-21. doi: https://doi.org/10.1093/eurheartj/ehy339

Downloads

Published

2020-12-28

How to Cite

1.
Rodionova V, Boiko O. Renal function and nutritional status in patients with arterial hypertension. Med. perspekt. [Internet]. 2020Dec.28 [cited 2024Dec.25];25(4):66-72. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/221231

Issue

Section

CLINICAL MEDICINE