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Glomerular Hyperfiltration Indicates Early Target Organ Damage in Essential Hypertension
Roland E. Schmieder, MD;
Franz H. Messerli, MD;
Guillermo Garavaglia, MD;
Boris Nunez, MD
JAMA. 1990;264(21):2775-2780.
Abstract
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In 111 patients with essential hypertension (World Health Organization stage I or II), we examined the relationship between renal hemodynamics and left ventricular hypertrophy. Left ventricular structure was determined by two-dimensional guided M-mode echocardiography, renal blood flow by iodine I 131 aminohippuric acid clearance, and glomerular filtration rate by creatinine clearance. The glomerular filtration rate correlated with left ventricular mass (r=.52) and left ventricular cross-sectional area (r=.21). Conversely, at a similar age, body mass index, body surface area, and arterial pressure, hypertensive patients with left ventricular hypertrophy disclosed a higher glomerular filtration rate and filtration fraction than those without left ventricular hypertrophy, whereas renal blood flow and renal vascular resistance measurements were not significantly different. Thus, at similar levels of arterial pressure and renal blood flow, glomerular hyperfiltration was linked to early cardiac structural changes in essential hypertension. We conclude that, in a hypertensive patient with normal renal function, a high glomerular filtration rate may be an indicator for early target organ damage in essential hypertension.
(JAMA. 1990;264:2775-2780)
Author Affiliations
From the Department of Medicine, University of Bonn, Bonn-Venusberg, Federal Republic of Germany (Dr Schmieder); and the Department of Internal Medicine, Section on Hypertensive Diseases, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, La (Drs Schmieder, Messerli, Garavaglia, and Nunez). Dr Schmieder is now with the University of Erlangen Nurnberg, Federal Republic of Germany.
Footnotes
Reprint requests to Department of Medicine, University of Erlangen Nurnberg, Korgumazgarten 14-18, 8500 Nurnberg 80, Federal Republic of Germany (Dr Schmieder).
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