Терапевтический архив (Apr 2010)
Hyperfiltration is an early sign of evolving chronic renal disease in males with metabolic syndrome
Abstract
Aim. To study the time course of changes in glomerular filtration rate (GFR) in different age groups of males with metabolic syndrome (MS). Subjects and methods. Eighty-six male patients with MS whose age 35 to 69 years (mean age 53.6 years) were examined. The patients were divided into 3 age groups: 1) 30-50 years (mean age 43.5 years; n = 30); 2) 50-60 years (mean age 54.9 years; n = 36); 3) 60-70 (mean age 66 years; n = 20). The study included only MS patients with stages I-III chronic renal disease (CRD) (according to the NKF K/DOQI classification, 2002). GFR was determined by the Cockroft-Gault formula corrected and uncorrected for a standard body surface area (GFRst, GFRc-g). The obtained values of GFRst and GFRc-g were compared with the population-based standards determined for each formula. The authors identified an increased GFRst (> 110 ml/min/1.73 m2), a normal GFRst (60-110 ml/min/1.73 m2), and a decreased GFRst ( 120 ml/min), a normal GFRc-g (80-120 ml/min), and a decreased GFRc-g (< 80 ml/min). GFRst < 60 ml/min/1.73 m2) was defined as CRD. Results. Each age group was found to have deviations of GFR from the normal values towards both its increase and decrease. The young age group showed a larger number of patients with increased GFR and a smaller number of patients with decreased GFR than did the old age group. This trend was seen for both GFRst and GFRc-g, but in the latter case, the spread of hyperfiltration was higher in the age group of 30-50 years and in the total group of patients. Conclusion. In the first age group, a predominance of hemofiltration precedes the development of CRD in the third age group and may reflect the trend of MS-induced renal lesion.