实用医学杂志2016，Vol.32Issue(7)：1104-1107,1108,5.DOI:10.3969/j.issn.1006-5725.2016.07.021
非糖尿病慢性肾病患者RASI治疗后醛固酮逃逸现象
Clinical observation and analysis of aldosterone escape in patients with non-diabetic nephropathy by RASI-therapy
摘要
Abstract
Objective To investigate the incidence and influencing factors of aldosterone escape in patients with non-diabetic nephropathy by RASI-therapy. Methods A total of 104 patients with non-diabetic nephropathy were treated with ARB or combination therapy of ACEI and ARB in a mean follow-up period of 12 months. Aldosterone escape was determined according to the change of plasma aldosterone concentration before and after treatment during 6-month and 12-month ACEI/ARB treatment, while the influencing factors of aldosterone escape in patients with non-diabetic nephropathy was also analyzed after therapy with RASI . Results In 12 months, the incidence of aldosterone escape was significantly higher than that in 6 months (26.92% vs. 14.42%, P = 0.007). After 12-month treatment, the difference was statistically significant in incidence of aldosterone escape among different stages of CKD (P = 0.027). Compared with 6-month incidence of aldosterone escape in the losartan group, 12-month incidence increased evidently (P = 0.020). The Ald level was positively correlated with urinary protein excretion and the Scr level (r = 0.431, P = 0.003 and r = 0.336, P = 0.009, respectively), and negetively correlated with levels of the eGFR (r = -0.275, P = 0.006). Univariate Logistic regression demonstrated that risk factors of aldosterone escape included pre-treatment values of the urinary protein excretion (OR = 3.671, P = 0.028) and the eGFR (OR = 0.972, P = 0.019). Multivariate Logistic model revealed pre-treatment values of the eGFR was positively associated with aldosterone escape (OR = 0.970, P = 0.012). Conclusion The incidence of the aldosterone escape increases along with the time of treatment. Renal function has correlated with aldosterone escape and pre-treatment value of the eGFR is an independent risk factor of aldosterone escape.关键词
慢性肾脏病/肾素-血管紧张素系统/醛固酮/醛固酮逃逸Key words
Chronic kidney disease/Renin-angiotensin system/Aldosterone/Aldosterone escape引用本文复制引用
杨庆春,罗慧洁,柏琳,施海涛,张志任..非糖尿病慢性肾病患者RASI治疗后醛固酮逃逸现象[J].实用医学杂志,2016,32(7):1104-1107,1108,5.基金项目
2012年度高等学校博士学科点专项科研基金 （）
