[Role of aldosterone in essential arterial hypertension complicated by chronic renal insufficiency].
The following parameters were studied in a group of patients suffering from essential arterial hypertension complicated by chronic renal insufficiency (CRI), mean age = 64.31 +/- 1.84, with creatinine clearance (CrC) ranging between 30 and 60 ml/min: blood pressure (systolic and diastolic arterial pressure), heart rate, plasmatic renin activity (PRA), plasma levels of aldosterone (ALDO) both in clino- and orthostatism, as well as some metabolic parameters. All parameters were compared with those in a group of age- and sex-matched patients with slight or moderate essential arterial hypertension. Before starting the study all patients completed a wash-out period of one week to annual the effects of other drugs which might interfere with the RAA system. PRA levels were within the norm, whereas plasma levels of ALDO were high both in clino- and orthostatism. ALDO levels were also found to be inversely correlated with those of CrC. From these data it emerges that hyperaldosteronism, as observed in these patients with CRI, is a relatively reliable marker of the extent of CRI and may occur independently of the activation of the RAA system, given that other factors, such as orthostatic stimulation, alterations in the acid-base equilibrium, and the degree of aldosterone hepatic and urinary clearance, contribute to its pathogenesis.
Nami
R
R
Istituto di Patologia Speciale Medica, Università degli Studi di Siena.
Martinelli
M
M
Buracchi
P
P
Lucani
B
B
Panza
F
F
Pavese
G
G
Carletti
F
F
Saia
F
F
Gennari
C
C
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000368:Aged; D000450:Aldosterone / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D002412:Cations / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006929:Hyperaldosteronism / Q000209:etiology*; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000502:physiology; D014527:Uric Acid / Q000097:blood
D002412:Cations; D014527:Uric Acid; D000450:Aldosterone; D000324:Adrenocorticotropic Hormone; D003404:Creatinine; D006854:Hydrocortisone
Ruolo dell'aldosterone nell'ipertensione arteriosa essenziale complicata da insufficienza renale cronica.