Ribstein J, du Cailar G, Mimran A
Combined renal effects of overweight and hypertension
Hypertension
(Oct) 26:610-615 1995
While hypertension is more common in obese individuals, the effects
of obesity on the target organs of hypertension have not been well
studied. Ribstein et al measured GFR and RPF using radioactive
tracers in 40 normotensive and 80 never-treated hypertensive
subjects, of which half were lean and half were to moderately obese
(body mass index 27-40 kg/m2). All were less than 60 years of age.
Glucose tolerance tests were done, and microalbuminuria was
quantified.
GFR and RPF were similar in lean and obese patients when corrected
for body surface area, but were greater in obese subjects if
corrected for height only. GFR correlated with protein intake, as
assessed by urinary urea excretion. Urinary albumin excretion was
higher in hypertensives than in normotensives, and higher in obese
normotensives and obese hypertensives than in their lean
counterparts, despite comparable levels of blood pressure. Fasting
serum insulin levels correlated with GFR but not RPF.
Comment: The authors are attempting to link obesity with
hyperfiltration and subsequent renal injury. Part of this depends
on how the values are corrected (height vs. BSA). However,the root
cause of the hyperfiltration observed in obese subjects might well
have been dietary, as the urinary urea excretions were 30-40%
higher in obese patients on average, than in their lean
counterparts.
(Daugirdas)
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H: Special problems :
Obesity, Insulin Resistance
H: Pathophysiology :
Kidney in hypertension