Renal function and nutritional status in patients with arterial hypertension

Abstract

Arterial hypertension is the main preventable cause of cardiovascular disease and all causes of death worldwide, and also ranks second among the most important causes of chronic kidney disease after diabetes. An important factor contributing to the increase in blood pressure is obesity. Being overweight raises blood pressure and accounts for 65-75% of the initial hypertension, which is the main cause of cardiovascular disease and kidney disease. The aim of the work was to study renal function in patients with arterial hypertension, depending on the nutritional status of patients. Materials and methods. A prospective study included 47 stable outpatients with stage II arterial hypertension (left ventricular hypertrophy) of the 1st to 3rd degree, (24 women and 23 men), the average age was 55.7 (8.9) years. The mean disease duration was 14 (3.2) years. The control group included 28 relatively healthy people without arterial hypertension (15 women and 9 men), the average age was 56.0 (6.6) years. All patients were evaluated for complaints, medical history, smoking status, physical examination with anthropometric indicators (height, weight, body mass index, waist circumference), heart rate and blood pressure. The risk of cardiovascular events was also determined in accordance with the SCORE scale. The nutritional status was evaluated based on bioimpedancemetry data (Omron analyzer) with determination of the percentage of total fat, muscle mass and visceral fat. To determine the functional state of the kidneys, the level of total protein in blood serum, creatinine and albumin in the urine was determined, with the determination of the albumin creatinine ratio in a single portion of urine, the glomerular filtration rate were calculated. Results and conclusions. In patients with arterial hypertension, a change in nutritional status was detected in the form of an increase in the amount of total adipose tissue against a background of a decrease in muscle tissue pool, with the development of sarcopenia in combination with obesity. Also, patients developed hypertensive nephropathy. It was found that the BMI is not informative enough to determine nutritional status, but requires the use of bioimpedancemetry to determine the percentage of total fat, visceral fat and muscle mass.