[Clinical and genetic basis of hypertensive nephrosclerosis. NEFROSEN Study].
BACKGROUND
Hypertensive nephrosclerosis is a chronic kidney disease (CKD) associated with essential hypertension. The lack of correlation between hypertension control and progression to end-stage CKD suggests an intrinsic and primitive disease. New evidence suggests that MYH9 gene alterations are associated with polymorphisms in African Americans. The aim of this study is to investigate whether a polymorphism of MYH9 in Caucasians is linked to essential hypertension and nephrosclerosis. The secondary objective is to identify the clinical risk factors of progression to end-stage CKD. This is a retrospective study that will compare patients with nephrosclerosis and essential hypertensives without renal disease, and also patients with nephrosclerosis and impaired renal function with those that are stable.


METHODS
Between October 2009 and October 2010, 500 patients with stages 3-5 CKD attributed to nephrosclerosis according to usual clinical criteria, and 300 essential hypertensives (eGFR>60 mL/min/1.73 m2; microalbuminuria <300 mg/g) are to be recruited. A total of 200 healthy controls from the general population are also to be included for the genetic study. There are two study sections, being the first and final visits to the clinic (for stage 5 cases, the start of replacement therapy will be the end of follow-up). Clinical and laboratory data will be recorded, and blood samples will be collected.


CONCLUSIONS
Our study will aim to determine if there is a relationship between the diagnosis of nephrosclerosis and the MYH9 gene in Caucasians, and to study possible risk factors for progression to end-stage CKD, on both clinical and genetic bases.
Sección de Nefrología, Hospital Valle del Nalón, Langreo, Asturias. beaojea@hotmail.com
B
B
Diez Ojea
R
R
Marín
E
E
Coto
F
F
Fernández Vega
R
R
Alvarez Navascués
G
G
Fernández Fresnedo
A
A
Pobes Martínez de Salinas
A
A
Suárez Laurés
C
C
García Monteavaro
M
M
Gorostidi
E
E
Sánchez
M
M
Arias
F
F
Ortega
D000328:Adult; D000368:Aged; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics*; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D020409:Molecular Motor Proteins / Q000235:genetics*; D015337:Multicenter Studies as Topic / Q000191:economics / Q000379:methods*; D018995:Myosin Heavy Chains / Q000235:genetics*; D009400:Nephrosclerosis / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000235:genetics*; D012109:Research Support as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D044465:White People / Q000235:genetics
C103814:MYH9 protein, human; D020409:Molecular Motor Proteins; D018995:Myosin Heavy Chains