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Распространенность нарушения функции почек при артериальной гипертонии (по данным эпидемиологического исследования ЭССЕ-РФ)
Распространенность нарушения функции почек при артериальной гипертонии (по данным эпидемиологического исследования ЭССЕ-РФ)
Ощепкова Е.В., Долгушева Ю.А., Жернакова Ю.В. и др. Распространенность нарушения функции почек при артериальной гипертонии (по данным эпидемиологического исследования ЭССЕ-РФ). Системные гипертензии. 2015; 12 (3): 19–24.
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Аннотация
Цель. Изучить распространенность нарушения функции почек, ее связь с артериальной гипертонией (АГ) и метаболическими факторами риска.
Материалы и методы. Проанализированы данные, полученные в рамках исследования ЭССЕ-РФ из 10 регионов Российской Федерации. Нарушения функции почек оценивались на основании расчета скорости клубочковой фильтрации (СКФ). Расчет СКФ проводился по Chronic Kidney Disease Epidemiology Collaboration (СКФ-EPI).
Результаты. Выявлена высокая распространенность снижения СКФ в обследованной популяции (76,8% – у женщин и 23,2% – у мужчин). Более неблагоприятная ситуация выявлена у пациентов с АГ и у пациентов с АГ и нарушением углеводного обмена или сахарным диабетом, у которых распространенность снижения СКФ выше, чем у пациентов без АГ и без нарушений углеводного обмена и сахарного диабета.
Заключение. Определена распространенность нарушения функции почек среди населения России. Установлена связь кардиометаболических факторов риска со снижением СКФ.
Ключевые слова: эпидемиологическое исследование, артериальная гипертония, скорость клубочковой фильтрации, факторы риска.
Materials and methods. Data from the ESSE-RF study from 10 regions of the Russian Federation are presented. Renal dysfunction was assessed on the basis of the calculation of glomerular filtration rate (GFR). GFR calculation was conducted on the Chronic Kidney Disease Epidemiology Collaboration (GFR-EPI).
Results. The study reveals a high prevalence of GFR decline in the population studied (76.8% in women and 23.2% in men). More unfavorable situation was found among the patients with hypertensionand in patients with hypertension and impaired glucose metabolism or diabetes mellitus, in which the prevalence of decrease GFR was higher than in patients without hypertension and without impaired glucose metabolism or diabetes mellitus.
Conclusion. Prevalence of renal dysfunction among the Russian population is defined. Associations of reduction in glomerular filtration rate with cardiometabolic risk factors are revealed.
Key words: epidemiological study, hypertension, glomerular filtration rate, risk factors.
Материалы и методы. Проанализированы данные, полученные в рамках исследования ЭССЕ-РФ из 10 регионов Российской Федерации. Нарушения функции почек оценивались на основании расчета скорости клубочковой фильтрации (СКФ). Расчет СКФ проводился по Chronic Kidney Disease Epidemiology Collaboration (СКФ-EPI).
Результаты. Выявлена высокая распространенность снижения СКФ в обследованной популяции (76,8% – у женщин и 23,2% – у мужчин). Более неблагоприятная ситуация выявлена у пациентов с АГ и у пациентов с АГ и нарушением углеводного обмена или сахарным диабетом, у которых распространенность снижения СКФ выше, чем у пациентов без АГ и без нарушений углеводного обмена и сахарного диабета.
Заключение. Определена распространенность нарушения функции почек среди населения России. Установлена связь кардиометаболических факторов риска со снижением СКФ.
Ключевые слова: эпидемиологическое исследование, артериальная гипертония, скорость клубочковой фильтрации, факторы риска.
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Materials and methods. Data from the ESSE-RF study from 10 regions of the Russian Federation are presented. Renal dysfunction was assessed on the basis of the calculation of glomerular filtration rate (GFR). GFR calculation was conducted on the Chronic Kidney Disease Epidemiology Collaboration (GFR-EPI).
Results. The study reveals a high prevalence of GFR decline in the population studied (76.8% in women and 23.2% in men). More unfavorable situation was found among the patients with hypertensionand in patients with hypertension and impaired glucose metabolism or diabetes mellitus, in which the prevalence of decrease GFR was higher than in patients without hypertension and without impaired glucose metabolism or diabetes mellitus.
Conclusion. Prevalence of renal dysfunction among the Russian population is defined. Associations of reduction in glomerular filtration rate with cardiometabolic risk factors are revealed.
Key words: epidemiological study, hypertension, glomerular filtration rate, risk factors.
Полный текст
Список литературы
1. Чазова И.Е., Жернакова Ю.В., Ощепкова Е.В. и др. Распространенность ФР сердечно-сосудистых заболеваний в российской популяции больных артериальной гипертонией. Кардиология. 2014; 10: 4–12. / Chazova I.E., Zhernakova Iu.V., Oshchepkova E.V. i dr. Rasprostranennost' FR serdechno-sosudistykh zabolevanii v rossiiskoi populiatsii bol'nykh arterial'noi gipertoniei. Kardiologiia. 2014; 10: 4–12. [in Russian]
2. Чазова И.Е., Ощепкова Е.В. Итоги реализации Федеральной целевой программы по профилактике и лечению артериальной гипертензии в России в 2002–2012 гг. Вестн. Российской академии медицинских наук. 2013; 2: 4–11. / Chazova I.E., Oshchepkova E.V. Itogi realizatsii Federal'noi tselevoi programmy po profilaktike i lecheniiu arterial'noi gipertenzii v Rossii v 2002–2012 gg. Vestn. Rossiiskoi Akademii meditsinskikh nauk. 2013; 2: 4–11. [in Russian]
3. Henry RM, Kostense PJ, Bos G et al. Mild renal insufficiency is associated with increased cardiovascular mortality: the Hoorn Study. Kidney Int 2002; 62: 1402–7.
4. Brantsma AH, Bakker SJ. Hillege HL et al. Urinary albumin excretion and its relation with C-reactive protein and the metabolic syndrome in the prediction of type 2 diabetes. Diabetes Care 2005; 28 (10): 2525–30.
5. Klausen KP, Scharling H, Jensen G et al. New definition of microalbuminuria in hypertensive subjects: association with incident coronary heart disease and death. Hypertension 2005; 46 (1): 33–7.
6. Schmieder RE, Schrader J, Zidek W et al. Low-grade albuminuria and cardiovascular risk: what is the evidence? Clin Res Cardiol 2007; 96 (5): 247–57.
7. Hallan S, Asberg A, Lindberg M et al. Validation of the Modification of Diet in Renal Disease formula for estimating GFR with special emphasis on calibration of the serum creatinine assay. Am J Kidney Dis 2004; 44 (1): 84–93.
8. Ibrahim S, Rashid L, Darai M. Modification of diet in renal disease equation underestimates glomerular filtration rate in egyptian kidney donors. Exp Clin Transplant 2008; 6 (2): 144–8.
9. Kim M-J, Lim N-K, Park H-Y. Relationship between prehypertension and chronic kidney disease in middle-aged people in Korea: the Korean genome and epidemiology study. BMC Public Health 2012; 12: 960.
10. Coresh J, Selvin E, Stevens LA et al. Prevalence of chronic kidney disease in the United States. JAMA 2007; 298: 2038–47.
11. Chadban SJ, Briganti EM, Kerr PG et al. Prevalence of kidney damage in Australian adults: The Aus Diab kidney study. J Am Soc Nephrol 2003, 14 (7 Suppl. 2): 131–8.
12. Asia pacific Cohort Studies Collaboration. The effects of diabetes on the risk of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care 2003; 26: 360–6.
13. Klag MJ, Whelton PK, Randall BL et al. End-stage renal disease in African-American and white men. 16-year MRFIT findings. JAMA 1997; 277 (16): 1293–8.
14. Chen J, Muntner P, Hamm L et al. The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med 2004; 140 (3): 167–74.
15. Palaniappan L, Carnethon M, Fortmann S. Association between microalbuminuria and the metabolic syndrome: NHANES III. Am J Hypertens 2003; 16 (11 Pt. 1): 952–8.
16. Despres J. Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk. Eur Heart J 2006; 8 (Suppl. B): 4–12.
17. Vassalotti JA, Stevens LA, Levey AS. Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 2007; 50 (2): 169–80.
2. Chazova I.E., Oshchepkova E.V. Itogi realizatsii Federal'noi tselevoi programmy po profilaktike i lecheniiu arterial'noi gipertenzii v Rossii v 2002–2012 gg. Vestn. Rossiiskoi Akademii meditsinskikh nauk. 2013; 2: 4–11. [in Russian]
3. Henry RM, Kostense PJ, Bos G et al. Mild renal insufficiency is associated with increased cardiovascular mortality: the Hoorn Study. Kidney Int 2002; 62: 1402–7.
4. Brantsma AH, Bakker SJ. Hillege HL et al. Urinary albumin excretion and its relation with C-reactive protein and the metabolic syndrome in the prediction of type 2 diabetes. Diabetes Care 2005; 28 (10): 2525–30.
5. Klausen KP, Scharling H, Jensen G et al. New definition of microalbuminuria in hypertensive subjects: association with incident coronary heart disease and death. Hypertension 2005; 46 (1): 33–7.
6. Schmieder RE, Schrader J, Zidek W et al. Low-grade albuminuria and cardiovascular risk: what is the evidence? Clin Res Cardiol 2007; 96 (5): 247–57.
7. Hallan S, Asberg A, Lindberg M et al. Validation of the Modification of Diet in Renal Disease formula for estimating GFR with special emphasis on calibration of the serum creatinine assay. Am J Kidney Dis 2004; 44 (1): 84–93.
8. Ibrahim S, Rashid L, Darai M. Modification of diet in renal disease equation underestimates glomerular filtration rate in egyptian kidney donors. Exp Clin Transplant 2008; 6 (2): 144–8.
9. Kim M-J, Lim N-K, Park H-Y. Relationship between prehypertension and chronic kidney disease in middle-aged people in Korea: the Korean genome and epidemiology study. BMC Public Health 2012; 12: 960.
10. Coresh J, Selvin E, Stevens LA et al. Prevalence of chronic kidney disease in the United States. JAMA 2007; 298: 2038–47.
11. Chadban SJ, Briganti EM, Kerr PG et al. Prevalence of kidney damage in Australian adults: The Aus Diab kidney study. J Am Soc Nephrol 2003, 14 (7 Suppl. 2): 131–8.
12. Asia pacific Cohort Studies Collaboration. The effects of diabetes on the risk of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care 2003; 26: 360–6.
13. Klag MJ, Whelton PK, Randall BL et al. End-stage renal disease in African-American and white men. 16-year MRFIT findings. JAMA 1997; 277 (16): 1293–8.
14. Chen J, Muntner P, Hamm L et al. The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med 2004; 140 (3): 167–74.
15. Palaniappan L, Carnethon M, Fortmann S. Association between microalbuminuria and the metabolic syndrome: NHANES III. Am J Hypertens 2003; 16 (11 Pt. 1): 952–8.
16. Despres J. Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk. Eur Heart J 2006; 8 (Suppl. B): 4–12.
17. Vassalotti JA, Stevens LA, Levey AS. Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 2007; 50 (2): 169–80.
2. Чазова И.Е., Ощепкова Е.В. Итоги реализации Федеральной целевой программы по профилактике и лечению артериальной гипертензии в России в 2002–2012 гг. Вестн. Российской академии медицинских наук. 2013; 2: 4–11. / Chazova I.E., Oshchepkova E.V. Itogi realizatsii Federal'noi tselevoi programmy po profilaktike i lecheniiu arterial'noi gipertenzii v Rossii v 2002–2012 gg. Vestn. Rossiiskoi Akademii meditsinskikh nauk. 2013; 2: 4–11. [in Russian]
3. Henry RM, Kostense PJ, Bos G et al. Mild renal insufficiency is associated with increased cardiovascular mortality: the Hoorn Study. Kidney Int 2002; 62: 1402–7.
4. Brantsma AH, Bakker SJ. Hillege HL et al. Urinary albumin excretion and its relation with C-reactive protein and the metabolic syndrome in the prediction of type 2 diabetes. Diabetes Care 2005; 28 (10): 2525–30.
5. Klausen KP, Scharling H, Jensen G et al. New definition of microalbuminuria in hypertensive subjects: association with incident coronary heart disease and death. Hypertension 2005; 46 (1): 33–7.
6. Schmieder RE, Schrader J, Zidek W et al. Low-grade albuminuria and cardiovascular risk: what is the evidence? Clin Res Cardiol 2007; 96 (5): 247–57.
7. Hallan S, Asberg A, Lindberg M et al. Validation of the Modification of Diet in Renal Disease formula for estimating GFR with special emphasis on calibration of the serum creatinine assay. Am J Kidney Dis 2004; 44 (1): 84–93.
8. Ibrahim S, Rashid L, Darai M. Modification of diet in renal disease equation underestimates glomerular filtration rate in egyptian kidney donors. Exp Clin Transplant 2008; 6 (2): 144–8.
9. Kim M-J, Lim N-K, Park H-Y. Relationship between prehypertension and chronic kidney disease in middle-aged people in Korea: the Korean genome and epidemiology study. BMC Public Health 2012; 12: 960.
10. Coresh J, Selvin E, Stevens LA et al. Prevalence of chronic kidney disease in the United States. JAMA 2007; 298: 2038–47.
11. Chadban SJ, Briganti EM, Kerr PG et al. Prevalence of kidney damage in Australian adults: The Aus Diab kidney study. J Am Soc Nephrol 2003, 14 (7 Suppl. 2): 131–8.
12. Asia pacific Cohort Studies Collaboration. The effects of diabetes on the risk of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care 2003; 26: 360–6.
13. Klag MJ, Whelton PK, Randall BL et al. End-stage renal disease in African-American and white men. 16-year MRFIT findings. JAMA 1997; 277 (16): 1293–8.
14. Chen J, Muntner P, Hamm L et al. The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med 2004; 140 (3): 167–74.
15. Palaniappan L, Carnethon M, Fortmann S. Association between microalbuminuria and the metabolic syndrome: NHANES III. Am J Hypertens 2003; 16 (11 Pt. 1): 952–8.
16. Despres J. Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk. Eur Heart J 2006; 8 (Suppl. B): 4–12.
17. Vassalotti JA, Stevens LA, Levey AS. Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 2007; 50 (2): 169–80.
________________________________________________
2. Chazova I.E., Oshchepkova E.V. Itogi realizatsii Federal'noi tselevoi programmy po profilaktike i lecheniiu arterial'noi gipertenzii v Rossii v 2002–2012 gg. Vestn. Rossiiskoi Akademii meditsinskikh nauk. 2013; 2: 4–11. [in Russian]
3. Henry RM, Kostense PJ, Bos G et al. Mild renal insufficiency is associated with increased cardiovascular mortality: the Hoorn Study. Kidney Int 2002; 62: 1402–7.
4. Brantsma AH, Bakker SJ. Hillege HL et al. Urinary albumin excretion and its relation with C-reactive protein and the metabolic syndrome in the prediction of type 2 diabetes. Diabetes Care 2005; 28 (10): 2525–30.
5. Klausen KP, Scharling H, Jensen G et al. New definition of microalbuminuria in hypertensive subjects: association with incident coronary heart disease and death. Hypertension 2005; 46 (1): 33–7.
6. Schmieder RE, Schrader J, Zidek W et al. Low-grade albuminuria and cardiovascular risk: what is the evidence? Clin Res Cardiol 2007; 96 (5): 247–57.
7. Hallan S, Asberg A, Lindberg M et al. Validation of the Modification of Diet in Renal Disease formula for estimating GFR with special emphasis on calibration of the serum creatinine assay. Am J Kidney Dis 2004; 44 (1): 84–93.
8. Ibrahim S, Rashid L, Darai M. Modification of diet in renal disease equation underestimates glomerular filtration rate in egyptian kidney donors. Exp Clin Transplant 2008; 6 (2): 144–8.
9. Kim M-J, Lim N-K, Park H-Y. Relationship between prehypertension and chronic kidney disease in middle-aged people in Korea: the Korean genome and epidemiology study. BMC Public Health 2012; 12: 960.
10. Coresh J, Selvin E, Stevens LA et al. Prevalence of chronic kidney disease in the United States. JAMA 2007; 298: 2038–47.
11. Chadban SJ, Briganti EM, Kerr PG et al. Prevalence of kidney damage in Australian adults: The Aus Diab kidney study. J Am Soc Nephrol 2003, 14 (7 Suppl. 2): 131–8.
12. Asia pacific Cohort Studies Collaboration. The effects of diabetes on the risk of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care 2003; 26: 360–6.
13. Klag MJ, Whelton PK, Randall BL et al. End-stage renal disease in African-American and white men. 16-year MRFIT findings. JAMA 1997; 277 (16): 1293–8.
14. Chen J, Muntner P, Hamm L et al. The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med 2004; 140 (3): 167–74.
15. Palaniappan L, Carnethon M, Fortmann S. Association between microalbuminuria and the metabolic syndrome: NHANES III. Am J Hypertens 2003; 16 (11 Pt. 1): 952–8.
16. Despres J. Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk. Eur Heart J 2006; 8 (Suppl. B): 4–12.
17. Vassalotti JA, Stevens LA, Levey AS. Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 2007; 50 (2): 169–80.
Авторы
Е.В.Ощепкова1, Ю.А.Долгушева1, Ю.В.Жернакова*1, И.Е.Чазова1, С.А.Шальнова2, Е.Б.Яровая1, О.П.Ротарь3, А.О.Конради3, С.А.Бойцов2 от имени участников исследования
1 Институт клинической кардиологии им. А.Л.Мясникова ФГБУ Российский кардиологический научно-производственный комплекс Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а;
2 ФГБУ Государственный научно-исследовательский центр профилактической медицины Минздрава России. 101990, Россия, Москва, Петроверигский пер., д. 10, стр. 3;
3 ФГБУ Северо-Западный федеральный медицинский исследовательский центр им. В.А.Алмазова Минздрава России. 197341, Россия, Санкт-Петербург, ул. Аккуратова, д. 2
*juli001@mail.ru
1 A.L.Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, 15а;
2 State Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation. 101000, Russian Federation, Moscow, Petroverigsky per., d. 10, str. 3;
3 V.A.Almazov Northwestern federal medical research center of the Ministry of Health of the Russian Federation. 197341, Russian Federation, Saint Petersburg, ul. Akkuratova, d. 2
*juli001@mail.ru
1 Институт клинической кардиологии им. А.Л.Мясникова ФГБУ Российский кардиологический научно-производственный комплекс Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а;
2 ФГБУ Государственный научно-исследовательский центр профилактической медицины Минздрава России. 101990, Россия, Москва, Петроверигский пер., д. 10, стр. 3;
3 ФГБУ Северо-Западный федеральный медицинский исследовательский центр им. В.А.Алмазова Минздрава России. 197341, Россия, Санкт-Петербург, ул. Аккуратова, д. 2
*juli001@mail.ru
________________________________________________
1 A.L.Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, 15а;
2 State Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation. 101000, Russian Federation, Moscow, Petroverigsky per., d. 10, str. 3;
3 V.A.Almazov Northwestern federal medical research center of the Ministry of Health of the Russian Federation. 197341, Russian Federation, Saint Petersburg, ul. Akkuratova, d. 2
*juli001@mail.ru
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