23 April 2003
Tubular injury: the first symptom of hypertensive kidney involvement?
Leszek Tylicki, Jacek Manitius, Wiesława Łysiak-Szydłowska, Bolesław RutkowskiMed Sci Monit 2003; 9(4): CR135-141 :: ID: 4696
Abstract
BACKGROUND: Tubular injury is an important component of hypertensive nephropathy, but its pathogenesis is not completely clear. We attempted to determine whether tubular injury precedes glomerular involvement, and to evaluate the role of vascular damage and metabolic disturbances in this process. MATERIAL/METHODS: 25 patients with newly diagnosed primary non-treated hypertension without microalbuminuria were studied. 15 healthy volunteers served as controls. We measured total urine activity of N-acetyl-beta-D-glucosaminidase (NAG) as a marker of tubular injury, albumin excretion, serum concentrations of insulin, uric acid and lipids. Intravenous glucose tolerance tests and oral fructose loading tests were performed to assess carbohydrate and purine metabolism. The plasma glucose area (PGA) under the curve of glucose levels obtained from the former test was calculated, as well as the plasma uric acid area (PUAA) under the curve of uric acid levels from the latter. Hypertensive vascular injury was investigated by direct ophthalmoscopy. RESULTS: Significantly higher NAG activity was found in hypertensives in comparison with healthy controls. NAG activity was not influenced by the extent of ophthalmoscopically detectable vascular injury. We found positive correlation between urine NAG activity and PGA. A borderline significant association was also found between NAG activity and PUAA in hypertensive patients. CONCLUSIONS: Our results suggest that tubular injury is present in the early stages of hypertensive nephropathy and may precede glomerular damage. Ischemia due to changes in small vessels may not be the only factor responsible for this injury. Metabolic disturbances, especially carbohydrate abnormalities, may also play a role.
Keywords: Acetylglucosaminidase - urine, Albuminuria - urine, Fructose - blood, Hypertension - urine, Kidney Diseases - urine
Editorial
01 April 2025 : Editorial
Editorial: Rapid Testing for the Avian Influenza A(H5N1) Virus is Urgently Required as Infections in Poultry and Dairy Cows are on the Rise, and so is Transmission to HumansDOI: 10.12659/MSM.949109
Med Sci Monit 2025; 31:e949109
In Press
Clinical Research
Dental Students’ Opinions on Use of Artificial Intelligence: A Survey StudyMed Sci Monit In Press; DOI: 10.12659/MSM.947658
Database Analysis
Defining Effect Size Standards in Temporomandibular Joint and Masticatory Muscle ResearchMed Sci Monit In Press; DOI: 10.12659/MSM.948365
Clinical Research
Evaluating Factors Influencing Periodontal Bone Loss Using Cone Beam Computed Tomography: A Retrospective S...Med Sci Monit In Press; DOI: 10.12659/MSM.947759
Database Analysis
Prognostic Significance and Immune Environment Analysis Using PANoptosis Molecular Clustering in Gastric Ca...Med Sci Monit In Press; DOI: 10.12659/MSM.947710
Most Viewed Current Articles
17 Jan 2024 : Review article 8,225,070
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
16 May 2023 : Clinical Research 703,027
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Mar 2024 : Editorial 30,424
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and ...DOI :10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
28 Jan 2024 : Review article 24,191
A Review of IgA Vasculitis (Henoch-Schönlein Purpura) Past, Present, and FutureDOI :10.12659/MSM.943912
Med Sci Monit 2024; 30:e943912