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PRÎMER HİPERTANSİYON: RENAL VASKÜLER DİSFONKSÎYON

PRIMARY HYPERTENSION: RENAL VASCULAR DYSFUNCTION

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Abstract (2. Language): 
Renal failure due to primary hypertension (HT) can be declined with precautions at early stages. In our study, glomerulo-tubular vascular function markers of 245 HT patients without end-organ damage have a mean age of 48±9 years, systolic blood pressure (SBP) 159±14, and diastolic blood pressure (DBP) 101+8 mmHg, were compared to 141 healthy individuals with a mean age of 46+9 and SBP, DBP 119+8, 78±5 mmHg respectively. According to control group, familial HT history, SBP, DBP (P<0.00001), body mass index (BMI, p<0.0001) and glucose (FBS, P<0.005) uric acid (UA, P<0.001) in serum, and daily urinary excretion ofprotein (UP, P<0.001), albumin (UAE), N-aceytl-D-glucosaminidase (NAG, p<0.00001), fi-2-microglobulin (film, P<0.005) were found to be elavated in HT group. A significant decline in serum Na+ was observed (P<0.05) in 110 patients whom SBP / DBP remained > 140 and/or 90 mmHg after a dietary salt restriction for one week. In BMI-II group (25-30 kg/m2) UA, UAE (P<0.001), NAG, film (P<0.005) levels were found to be higher than in BMI-I (<25 kg/m2) group. Positive correlations were found between hypertensive retinopathy (%59-HR) to patient's age, HT duration, SBP, DBP UA; and between smoking to UA, hemoglobin (Hb) and between FBG to BMI, serum Na+ in HT group. When compared to healtys', increased FBG (P<0.05) sCr (P<0.005) UA, UAE (P<0.0005), in hypertensive males and elevated Hb, fi2m (P<0.005), BMI, UP (P<0.0005), UA, UAE, NAG (P<0.00005) in hypertensive females were found. Our findings suggest that renal vascular dysfunctions were occurred at early stages in HT, males have tendency to systemic, females to renal vascular damages are increased with obesity, smoking, salt.
Abstract (Original Language): 
Primer Hipertansiyon (HT)'a bağlı böbrek yetmezliklerinin gelişimi erken evrede alınan önlemlerle azaltılabilmektedir. Çalışmamızda, yaş ortalaması 48+9 yıl, sistolik/diyastolik kan basıncı (SKB/DKB) 159+14 / 101+8 mmtig olan, hedef organ hasarsız 245 HTlu ile yaş ortalaması 46+9 yıl, SKB/ DKB 119+8/ 78±5 mnıHg olan 141 sağlıklı bireyin, glomerülo-tubiiler vasküler fonksiyon göstergeleri karşılaştırıldı. Sağlıklı gruba göre, ailede HT öyküsü, SKB, DKB (p<0.00001), vücut kitle indeksi (VKİ, p<0.0001) ile serumda; glukoz (AKŞ, p<0.005), ürik asit (ÜA) ve günlük idrarla atılan protein (UP, P<0.001), albumin (UAE), N-Asetil-D-glukosaminidaz (NAG, P<0.00001), b-2-mikroglobülin (b2m, P<0.005) değerleri HT grubunda yüksek bulundu. Bir hafta diyet tuzunu azaltmaları önerilen 137 hastadan KB >140 ve/ ya 90 mmHg de kalan 110 ununda, serum Na* unda anlamlı düşüş gözlendi (P<0.05). VKİ-II. derece (25-30 kg/m2) olan hastaların ÜA, UAE(P<0.001), NAG, b2m ıP<0.005) değerleri VKİ-I. derece (< 25 kg/m2) olanlardan yüksek bulundu. Hipertansif retinopati (% 59) ile hasta yaşı ve HT süresi, SKB, DKB, ÜA; sigara ile ÜA, hemoglobin (Hb); AKŞ ile VKİ, Na+ arasında pozitif ilişki saptandı. Sağlıklı gruba göre, hipertansif erkeklerin AKŞ (P<0.05), sKr (P<0.005), UAE P<0.0005) ve hipertansif kadınların Hb, b2m P<0.005), VKİ, UP (P<0.0005), UA, UAE, NAG p<0.00005) değerleri artmış bulundu. Çalışmamızda, renal vasküler fonksiyonların HT'nun erken evresinde " jzulduğunu, erkeklerin sistemik vasküler, kadınların renal vasküler bozulmaya daha yatkın olduğunu, obezite, sigara, tuzla vasküler bozulmanın arttığım gözledik.
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