Glomerularna hiperfiltracija kao predkazatelj bubrežnoga oštećenja i povećanoga kardiovaskularnoga rizika u predhipertoničara

doctoral thesis

• Title (english): Glomerular hyperfiltration as a predictor for renal impairment and increased cardiovascular risk in prehypertension
• Author: Ana Jelaković
• Mentor: Mario Laganović (mentor)
• Committee member: Krešimir Galešić (predsjednik povjerenstva)
• Committee member: Jerko Barbić (član povjerenstva)
• Committee member: Davor Miličić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2022-10-03, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Glomerularna hiperfiltracija povezana je s bržim napretkom bubrežne bolesti, te se smatra ranim markerom (ranijim nego albuminurija) bubrežnog oštećenja u dijabetesu i arterijskoj hipertenziji. U predhipertenziji rizik za razvoj albuminurije i kronične bubrežne bolesti nije sasvim jasan. Kako je pojavnost predhipertenzije vrlo velika u općoj populaciji, a glomerularna hiperfiltracija se najčešće susreće kod mlađih osoba, pretilih, onih s kongenitalnim ili stečenim gubitkom broja nefrona, te pušača, željeli smo istražiti postoji li nezavisan odnos glomerularne hiperfiltracija u predhipertoničara i potom u cijeloj skupini opće populacije naspram drugih kardiovaskularnih čimbenika rizika, te u kojoj mjeri u prospektivnom praćenju glomerularna hiperfiltracija dovodi do KBB i KV incidenata. U ovo istraživanje inicijalno je bilo uključeno 1106 ispitanika iz opće ruralne poopulacija kontinentalne Hrvatske. U praćenju su analizirani podaci 406 ispitanika. Ispitanici su podijeljeni u 6 skupina ovisno o kategoriji eGFR, te su promatrane razlike između skupina u presjećnom dijelu istraživanja, dok se u longitudinalnom dijelu gledala razlika između skupina ovisno o kretanju eGFR pojedinca za vrijeme praćenja. U longitudinalnom praćenju ispitanici s GHF na početku praćenja su imali statistički najveći pad eGFR, te najveću kumulativnu stopu incidencije albuminurije. Unutar skupine predhipertoničara nisu nađene statistički značajne razlike u antropometrijskim, laboratorijskim ili parametrima KV rizika između kategorija eGFR. Novonastaloj AH najviše je pridonosila dob ispitanika i abdominalna pretilost, dok je rizik za novonastalu AH bio najveći kod ispitanika s najvećim godišnjim padom eGFR. GHF nije bila povezana s novonastalom AH. Nismo uočili statistički značajne antropometrijske, laboratorijske ili razlike u AT između skupina ispitanika ovisno o kretanjima eGFR na početku i na kraju praćenja.

Abstract (english)

Glomerular hyperfiltration is associated with more rapid decline in renal function resulting in chronic kidney disease. It is considered to be an early marker (earlier than albuminuria) of renal impairment in diabetes and hypertension. In prehypertension risk of development albuminuria and chronic kidney disease is not so clear. Since prevalence of prehypertension is high in general population and glomerular hyperfiltration is often found in younger individuals, obese, those with congenital or acquired loss of nephron mass and smokers, it was our aim to investigate whether relationship between glomerular hyperfiltration in prehypertension and other cardiovascular risk factors is independent. Also, in prospective part od the study aim was to investigate whether glomerular hyperfitration leads to chronic kidney disease and cardiovascular disease. Initial enrollment included 1106 examinees from general ruraln population. Prospective dana was analysed for 406 examinees. Zje examinees were devided into 6 groups according to eFR cathegory and differences were analized in crosssectional part of the study while in longitudinal part of the study analized differences between examinees according to their eGFR trend during follow-up period. In follow-up the examinees with lomerular hyperfiltration had statistically the biggest drop in eGFR and the highest cummulative incidence rate of albuminuria. Among prehypertensive group within different eGFR cathegories no significant differences were observed regarding anthropometric, laboratory findings or cardiovascular score risk paramethers. Newly diagnosed hypertension age and abdominal obesity contributed the most, while the risk for new onset hypertension was highes in examinees with bigest annula eGFR drop. No statistically significant differences were observed in anthropometric, laboratory findings or cardiovascular score risk paramethers among groups with different eGFR changes during follow-up period.

• Keywords: glomerularna hiperfiltracija; predhipertenzija; bubrežna bolest; kardiovaskularni rizik
• Keywords (english): glomerular hyperfiltration; prehypertension; chronic kidney disease; cardiovascular risk
• Language: croatian
• URN:NBN: urn:nbn:hr:105:849877
• Project: Number: 108-0000000-0329; Title: ENDEMSKA NEFROPATIJA U HRVATSKOJ, epidemiologija, dijagnostika i etiopatogeneza; Title: ENDEMIC NEPHROPATHY IN CROATIA, epidemiology, diagnosis, etiopathogenesis; Leader: Bojan Jelaković; Jurisdiction: Croatia; Funder: MZOS; Funding stream: ZP
• Project: Number: 04/38; Title: Molekulsko profiliranje i proteomika karcinoma urotela; Leader: Bojan Jelaković; Jurisdiction: Croatia; Funder: HRZZ; Funding stream: PA
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 217 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-11-29 12:24:23