| Objective: By camparing the difference of UACR(urinary microalbumin/creatinine ratio, UACR), SCr(serum creatinine), and Scy C(serum cystatin C) value in ageing patients with hypertension and non hypertension, were the characteristics of UACR, SCr, and Scy C values in aging hypertension patients or non hypertension patients with or without occurence of early renal damage analyzed. To evaluate the diagnostic value of UACR, SCr and Scy to early renal damage in aging hypertension patients.Methods:1. Between January 2013 and June 2015, 200 patients with hypertension and 70 non-hypertension subjects admitted to department of cardiology were selected in Beijing Nuclear Industry Hospital as the hypertension group, and 70 non hypertension inpatients were selected as the control group, all of them were more than 60 years old. Morning urine and fasting blood samples in two groups patients were collected to measure UACR, SCr, and Scy C levels, and compare these indexes of the two groups.2. According to hypertension’s level,the hypertension patients were divided into three groups with grade 1,2 and 3, and the difference of the mean value of UACR, SCr, and Scy C levels among the groups was observed.3. In addition, as the key criterion, renography were examined in the observation group and control group to evaluate renal function. According the results of renography, the patients were divided into normal renal function group and renal damage group. Using renography result to evaluate the specificity, sensitivity and correlation between UACR, SCr, Scy C’s levels and the diagnosis of early renal damage in hypertension patients.Results:1. The mean values of Ln UACR(3.82±1.13) and Scy C(2.31±0.32 mg/L) in the observation group were significantly higher than those in the control group [Ln UACR(2.93±0.89) and Scy C(0.84±0.11 mg/L)](P<0.05), but the SCr value between the two groups was not significant different(79.31±25.33 umol/L for the observation group and 75.76±22.89 umol/L for the control group)(P>0.05);2. The Scy C values were significant different among all of the groups(P<0.05),control groups as(0.84±0.11 mg/L), hypertension grade 1 as(1.53 ± 0.47* mg/L), hypertension grade 2 as(2.62±0.73*a mg/L), and hypertension grade 3 as(3.43±0.38*ab mg/L).The Scr values were significant different(P<0.05) between hypertension grade 3(96.74 ± 28.98*a umol/L) and 1(79.62 ± 19.67 umol/L).The Ln UACR values were significant different(P<0.05) between hypertension and control groups(2.93±0.89), hypertension grade 3(4.01±1.34*a) and 1(3.21±0.92*), hypertension grade 2(3.69±1.17*a) and 1(3.21±0.92*).3. The levels of Scy C and Ln UACR were significantly negatively related to the GFR of renography in aging hypertension patients(r=-0.68,P<0.05;r=-0.45,P<0.05 respectively).4. According GFR from renography, 69 patients had normal renal function, 131 patients’ renal function had damaged in the observation group and 45 patients had normal renal function, 21 patients’ renal function had damaged in the control group. Compared with renal function damaged group in control, the Ln UACR [(3.97±0.58)vs.(2.89±0.68)] and Scy C levels [(3.12±0.27 mg/L)vs.(1.05±0.23 mg/L)] were significantly higher in renal function damaged group in hypertension(P<0.05); Compared with renal function normal group in control, the Ln UACR [(3.11±0.33)vs.(2.79±0.74)] and Scy C levels [(1.57±0.39 mg/L) vs.(0.82±0.16 mg/L)] were significantly higher in renal function normal group in hypertension(P<0.05); Compared with renal function normal group in hypertension, the Ln UACR [(3.97±0.58)vs.(3.11±0.33)] and Scy C levels [(3.12±0.27 mg/L) vs.(1.57±0.39 mg/L)] were significantly higher in renal function normal group in hypertension(P<0.05);5. The sensitivity and specificity of UACR, Scy C, SCr: The specificity of UACR, Scy C and SCr in the diagnosis of early renal damage were 89.12%, 96.7% and 100%, sensitivity were respectively 44.27%, 54.69% and 19.45%; The specificity of UACR+Scy C in the diagnosis of early renal damage were 95.86% and sensitivity were 74%;when UACR, SCys and SCr were used to diagnose early renal damage of hypertension, the areas under the ROC curve were 0.68, 0.79 and 0.61 respectively.Conclusion:1. The patients of aging hypertension had significantly higher levels of UACR and Scy C, and difference changed significantly with the increase of blood pressure. There was significantly difference in Scr values only in the late stage of hypertension. USCR and Scy C are important for diagnosis with early renal damage in aging hypertension.2. The levels of UACR and Scy C were significantly negatively related to the GFR of renography in aging hypertension patients, indicating that UACR and Scy C could reflect the change of renal function exactly.3. SCr could not timely reflect the changes of damaged renal function, and when it combines with the examinations of UACR and SCys, the changes of early renal damage by hypertension could in time be found. That is important for diagnosis. |
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