12.13 Estimated GFR is Associated with Endothelium-Independent Vasodilation in the Forearm Microcirculation of Hypertensive Patients
Introduction. The relation between endothelial and renal function in patients with normal or mildly reduced renal function is still controversial.
Aim. To evaluate the relationship between the endothelium-dependent (EDV) and independent (EIV) vasodilation in the forearm microcirculation and the estimated glomerular filtration rate (eGFR) in a population of untreated hypertensive patients without previous cardiovascular (CV) events.
Methods. 315 patients (age 24–78 years; 83% males; 19% smokers; LDL-cholesterol 138.4±31.8 mg/dl; blood glucose 96.0±15.4 mg/dl) were recruited. eGFR was calculated by the Modification of Diet in Renal Disease formula. EDV and EIV were evaluated as maximal forearm vasodilation to intraarterial infusion of acetylcholine and sodium nitroprusside, respectively.
Results. mean eGFR was 83.5±18.9 (range 51–132) ml/min and 71% of patients had eGFR <90 ml/min. eGFR was directly correlated to both EDV (r=0.15; p<0.05) and EIV (r=0.40; p<0.001). Moreover, logistic analysis revealed that patients in the lowest and middle tertile of EIV showed an odds ratio of 2.83 (1.64–5.11, 95% C.I.) and 1.87 (1.12-3.43, 95%C.I.) of having eGFR<90 ml/min as compared to highest tertile, respectively. Moreover, when multivariate analysis was applied (age and sex, parameters used in the calculation of eGFR, were not included), only systolic blood pressure, LDL-cholesterol, smoking habit and EIV were independent predictors of eGFR.
Conclusions. Our data show that in hypertensive patients with various associated cardiovascular risk factors, EIV but not to EDV is associated to eGFR, suggesting that the presence of structural alterations, rather than endothelial dysfunction might be a marker or a mechanism of mild impairment of renal function.
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Versari, D., Virdis, A., Ghiadoni, L. et al. 12.13 Estimated GFR is Associated with Endothelium-Independent Vasodilation in the Forearm Microcirculation of Hypertensive Patients. High Blood Press Cardiovasc Prev 15, 322 (2008). https://doi.org/10.1007/BF03263734