Relationship Between Renal Arteriosclerosis And Early Impairment Of Renal Function In Elderly Patients With Essential Hypertension

ObjectiveTo investigate the correlation between renal arteriosclerosis and early kidney damage in the elderly hypertensive population,so as to provide basis for the judgment of early kidney damage,early treatment and to prevent the deterioration of the disease.MethodsThe subjects of the study were hypertensive patients in the affiliated hospital of Inner Mongolia medical university from July 2018 to July 2019.A total of 150 hypertensive patients ranged from 5 to 10 years with an average age of 70.136.76 years were selected randomly including 50 cases of hypertension grade 1,50 cases of hypertension grade 2 and 50cases of hypertension grade3.A total of 50 patients without hypertension and kidney diseases,with an average age of 70.136.76 years was selected as control.All subjects met the following diagnostic criteria and inclusion&exclusion criteria,voluntarily participated in the study and signed the informed consent.The contents of serum cystatin C(Cys C),serum retinol binding protein(RBP),serum?2-microglobulin(?2-MG)and Creatinine(Cr)in serum and urinary albumin-to-creatinine(UACR)and N-acetyl-D-glucosidase(NAG)in urine were measured.The Renal resistance index(RRI)of each renal artery was measured by color doppler ultrasound.The glomerular filtration rate(GFR)was calculated,and the subjects were divided into?120 ml/min group,90-120 ml/min group,and 60-90 ml/min group according to the GFR.SPSS 23.0(SPSS Inc.,Chicago,USA)was used for statistical analysis,and the significance test level was?=0.05.Results1.The contents of Cysc,RBP,?2-MG,UACR and NAG were highest in the hypertension grade 3 group,followed by the hypertension grade 2 group,and the lowest was in the control group.The difference was statistically significant(P<0.05).The contents of SLRI,SRRI,GLRI,GRRI,MLRI,MRRI,LLRI and LRRI~2were the highest in the hypertension level 3 group,followed by the hypertension level 2 group,and the lowest was in the control group,with statistically significant differences among the groups(P<0.05).2.The contents of Cysc?RBP??2-MG?UACR and NAG were higher in hypertension groups than control when 90ml/min?GFR<120 ml/min and 60ml/min?GFR<90ml/min,with significantly difference(P<0.01),while no significantly difference when GFR?120ml/min.3.The Renal artery renal resistance index SLRI?SRRI?GLRI?GRRI?MLRI?MRRI?LLRI and LRRI was higher in hypertension groups than control group when GFR was between 90 to 120 ml/min or between 60 to 90 ml/min and the difference was statistically significant(P<0.05).There are no significantly difference when GFR?120ml/min.4.In grade 1 hypertension group,Cys C?UACR and NAG were positively correlated with Renal artery renal resistance index(P<0.05)and?2-MG was positively correlated with SLRI?SRRI?GLRI?GRRI?MLRI and MRRI(P<0.05).In grade 2 hypertension group,NAG was positively correlated with SLRI,SRRI,GLRI and GRRI(P<0.05)and?2-MG was positively correlated with all renal arteriosclerosis indexes except LLRI(P<0.05).In grade 3hypertension group,Cys C was positively correlated with SLRI,SRRI and MLRI(P<0.05)and RBP and SLRI was positively correlated with SRRI(P<0.05),while UACR was negatively correlated with SLRI,SRRI and GRRI(P<0.05).Conclusion1.The contents of Cys C,?2-MG and RBP in serum,UACR and NAG in urine and Renal resistance index were correlated with blood pressure and early renal damage in elderly people,which indicated early kidney damage in hypertension group and the damage was more serious with the increase of blood pressure.2.The correlations between indicators of early kidney damage and renal artery resistance indexes had their own traits when early kedney damage occurs in hypertension in elderly people.