TY - JOUR
T1 - An in-depth examination of the excretion of albumin and other sensitive markers of renal damage in mild hypertension
AU - Mueller, Patricia W.
AU - Dallas Hall, W.
AU - Caudill, Samuel P.
AU - MacNeil, Mary Louise
AU - Arepally, Arvin
N1 - Funding Information:
Received February 9, 1995. Accepted Mav 23, 1995. lthough albumin excretion has been exam-National Center for Environmental Health, Centers for Disease From the Division of Environmental Health Laboratory Sciences, ined extensively in hypertension associ-Control and Prevention, Public Health Service, US Department of ated with diabetes mellitus, there is much Health and Human Services, Atlanta, Georgia (PWM, SPC, MLM), A less information on albumin excretion in (WDH, AA). and Emory University School of Medicine, Atlanta, Georgia hypertension not associated with diabetes, and there The use of trade names is for identification only and does not are few estimates of the prevalence of elevated uri- constitute endorsement by the Public Health Service or by the US nary albumin values in this population. Elevated al-This study was supported in part by Public Health Service Grant Department of Health and Human Services. bumin excretion (sometimes referred to as microalbu-#MO1-RR00039 from the General Clinical Research Centers Pro- minuria or, at overtly higher levels, as proteinuria) gram, National Institutes of Health, National Center for Research has been associated with an increased risk of end-Address correspondence and reprint requests to Patricia W. Resources. stage renal disease, retinopathy, cardiovascular dis-Mueller, PhD, Centers for Disease Control and Prevention, Mail- ease, and mortality among people with insulin- stop F50, 4770 Buford Highway RE, Atlanta, GA 30341-3724. dependent diabetes mellitus (IDDM), M7 and primar-
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1995/11
Y1 - 1995/11
N2 - In an in-depth examination to better define the renal effects of mild hypertension, we used urinary proteins to indicate damage to the glomerulus (albumin), tubular reabsorption capability (retinolbinding protein), and turnover of tubular tissue (alanine aminopeptidase and N-acetyl-β-d-glucosaminidase) in a group of 18 people with mild hypertension not associated with diabetes and a control group (n = 12). The participants' activity was controlled on a high normal salt diet for 3 days followed by a low salt diet for 4 days. Two distinct patterns of albumin excretion were evident in the hypertensive group: 22% had elevated, highly variable excretion patterns, and the rest had tightly grouped values below 16 mg/g creatinine, 16 μg/min, or 16 mg/L, with the lowest within-person biological variability given by albumin calculated as a ratio to creatinine. Albumin and NAG excretion primarily correlated with systolic blood pressure and the best correlations were given by ratios to creatinine. A marked decrease in salt excretion of 71% (to 50.8 mEq/day) resulted in significant (P < .0005) decreases in systolic (13.9 mm Hg), diastolic (6.4 mm Hg), and mean arterial pressures (8.9 mm Hg) only in the group with mild hypertension. However, albumin excretion did not decrease when dietary salt content was lowered. The group with hypertension also had higher urinary excretion of lysosomal N-acetyl-β-d-glucosaminidase (P < .01), and whites in the group had a higher excretion of retinol-binding protein than did whites in the control group (P < .02). Retinol-binding protein values, however, were within the normal range, indicating that the elevated albumin values were the result of changes in selectivity of the glomerulus.
AB - In an in-depth examination to better define the renal effects of mild hypertension, we used urinary proteins to indicate damage to the glomerulus (albumin), tubular reabsorption capability (retinolbinding protein), and turnover of tubular tissue (alanine aminopeptidase and N-acetyl-β-d-glucosaminidase) in a group of 18 people with mild hypertension not associated with diabetes and a control group (n = 12). The participants' activity was controlled on a high normal salt diet for 3 days followed by a low salt diet for 4 days. Two distinct patterns of albumin excretion were evident in the hypertensive group: 22% had elevated, highly variable excretion patterns, and the rest had tightly grouped values below 16 mg/g creatinine, 16 μg/min, or 16 mg/L, with the lowest within-person biological variability given by albumin calculated as a ratio to creatinine. Albumin and NAG excretion primarily correlated with systolic blood pressure and the best correlations were given by ratios to creatinine. A marked decrease in salt excretion of 71% (to 50.8 mEq/day) resulted in significant (P < .0005) decreases in systolic (13.9 mm Hg), diastolic (6.4 mm Hg), and mean arterial pressures (8.9 mm Hg) only in the group with mild hypertension. However, albumin excretion did not decrease when dietary salt content was lowered. The group with hypertension also had higher urinary excretion of lysosomal N-acetyl-β-d-glucosaminidase (P < .01), and whites in the group had a higher excretion of retinol-binding protein than did whites in the control group (P < .02). Retinol-binding protein values, however, were within the normal range, indicating that the elevated albumin values were the result of changes in selectivity of the glomerulus.
KW - Albumin
KW - N-acetyl-β-d-glucosaminidase
KW - alanine aminopeptidase
KW - creatinine
KW - glomerulus
KW - kidney damage
KW - mild hypertension
KW - retinol-binding protein
KW - salt
UR - http://www.scopus.com/inward/record.url?scp=0028789762&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028789762&partnerID=8YFLogxK
U2 - 10.1016/0895-7061(95)00231-D
DO - 10.1016/0895-7061(95)00231-D
M3 - Article
C2 - 8554730
AN - SCOPUS:0028789762
VL - 8
SP - 1072
EP - 1082
JO - American journal of hypertension
JF - American journal of hypertension
SN - 0895-7061
IS - 11
ER -