Independent association of FTO rs9939609 polymorphism with overweight and obesity in Polish adults. Results from the representative population-based WOBASZ study.

Genetic factors play an important role in the origin of obesity. We investigated the association between the FTO rs9939609 genotype and overweight and obesity, along with additional anthropometric variables in the representative sample of adult Polish population. We genotyped a random sample of 3369 adult individuals examined in a cross-sectional population survey (WOBASZ 2003-2005). More than 40% of men and women had at least one A allele. The AA genotype was found in approximately one fifth of both men and women. The frequency of the AA genotype increased with higher BMI in both sexes and was associated with higher anthropometric obesity indicators in both men and women. The FTO rs9939609 AA genotype was significantly related to abnormal BMI [OR=1.55 (1.14-2.11)] and overweight [OR=1.55 (1.11-2.16)] or obesity [OR=1.56 (1.04-235)] in men regardless of age, tobacco smoking, physical activity, diet and diabetes, while in women it was related to abnormal BMI [OR=1.45 (1.05-2.01)] and overweight [OR=1.59 (1.11-2.29)] after adjustment in addition for menopause. The frequency of the A allele in the Polish population was the same as in other European countries. About one fifth of both men and women have the FTO rs9939609 AA variant. A significant relationship was found between the FTO genotype and anthropometric obesity indicators. The AA genotype was significantly associated with abnormal BMI and overweight in both sexes, but the relation to the obesity phenotype was observed only in men.

Prevalence of diabetes and impaired fasting glucose in Poland in 2005-2014: results of the WOBASZ surveys.

AIMS: To evaluate the prevalence of diabetes and impaired fasting glucose in Poland in 2013-2014 and to determine the temporal trends between 2003-2005 and 2013-2014. METHODS: A questionnaire survey was conducted in a representative sample of Polish adults, complemented by anthropometric and fasting plasma glucose measurements. The research was part of the national cross-sectional WOBASZ study. Diabetes was assessed as self-reported or screened (fasting plasma glucose level ≥ 7 mmol/l, based on one blood sample). RESULTS: In the years 2013-2014 among 5694 participants aged 20-74 years, 6.0% (95% CI 5.4-6.6) reported a previous diagnosis of diabetes (5.8% in women and 6.2% in men). In addition, 2.4% of the participants (95% CI 2.0-2.8) without a previous diagnosis of diabetes (1.8% of women and 3.1% of men) had a fasting blood glucose level ≥7.0 mmol/l in a single measurement. In a single measurement, 18.4% of the participants (95% CI 17.4-19.4; 13.2% of women and 23.8% of men) had impaired fasting glucose. The prevalence of dysglycaemia in the WOBASZ II study was significantly higher compared to the WOBASZ I study findings from 2003-2005, increased from 6.6% to 8.4% for diabetes and from 9.3% to 18.4% for impaired fasting glucose (after age and sex standardization to the 2013 Polish population). CONCLUSIONS: The prevalence of diabetes in Poland is similar to that observed in other European populations and has increased significantly over the last decade.

Serum from patients with chronic obstructive pulmonary disease promotes proangiogenic behavior of the vascular endothelium.

OBJECTIVE: It has been documented that COPD is a risk factor for lung cancer. In COPD patients, changes in lung angiogenesis - a critical process in the development of lung cancer - have been poorly investigated. We aimed to determine whether serum from COPD patients could promote the proangiogenic capabilities of endothelial cells in vitro. PATIENTS AND METHODS: The research was carried out using sera from COPD patients and healthy volunteers, endothelial cells EA.hy926, and bronchial epithelial cells. The concentration of angiogenic molecules was quantified using ELISA tests. The proliferation and migration of EA.hy926 were tested using fluorescence-based methods. Tube formation was analyzed with a commercially available assay. RESULTS: Sera from COPD patients and conditioned media generated by epithelial cells exposed to these sera stimulate proliferation, but not migration, of EA.hy926. This coincided with increased tube formation in both experimental regimens. The sera from COPD patients contained increased levels of CCL2, CCL21, and HGF, whereas the conditioned media generated by epithelial cells treated with these sera exhibited increased levels of CCL2, CCL21, CXCL8, FGF, and sICAM-1. The concentration of angiogenic markers in the sera and conditioned media, and their effect on the behavior of the endothelium were independent of smoking status (COPD and controls), stage of obstruction, and disease group (COPD). CONCLUSIONS: The increased incidence of lung malignancy in COPD patients may be associated, at least to some extent, with the direct and indirect proangiogenic activity of their sera (via alterations in the secretome of epithelial cells).

Socio-demographic and lifestyle correlates of commuting activity in Poland.

OBJECTIVES: The aim of this study is to analyse the epidemiology of active transportation and to investigate the relationship between commuting physical activity (PA) and socio-demographic and lifestyle characteristics in Poland. METHODS: A cross sectional analysis was conducted among 7280 randomly selected individuals (3747 men and 3533 women) aged 20-74 years participating in the National Multicentre Health Survey WOBASZ (2002-2005). Socio-demographic, smoking and physical activity details were assessed by an interviewer-administered questionnaire. RESULTS: Only 36% of the participants (30% men and 42% of women) are active commuters. Moreover, 55.4% of them spend less than 15 min/day on walking or cycling. The highest risk of commuting inactivity was noticed among residents of large urban settings, with university education, the highest income and low occupational PA in both genders. Smoking and leisure-time PA were not significantly associated with commuting activity. CONCLUSIONS: Active commuting is not common in Poland. There are several differences in commuting patterns as compared with the US or Western European populations. Due to important differences between various socio-demographic groups, future interventions should be specific for the targeted subpopulations.

Association between anthropometric obesity measures and coronary artery disease: a cross-sectional survey of 16,657 subjects from 444 Polish cities.

BACKGROUND: Excessive body weight is known to cluster with cardiovascular (CV) risk factors, but it is not clear which anthropometric obesity measure provides best independent predictive value of coronary artery disease (CAD). METHODS AND RESULTS: We explored associations between CAD and four different obesity measures (body mass index (BMI), waist circumference, waist/height and waist/height(2)) in a cohort of 16 657 subjects (40.4% men; 20.8% CAD patients), recruited by 700 primary care physicians in 444 Polish cities. 42.8% of subjects were classified as overweight, 31.7% as obese and 39.8% had abdominal obesity. In univariate analyses all obesity measures correlated with CAD (p>0.001), but waist/height(2) was the strongest discriminator between CAD patients and controls. Age-adjusted and sex-adjusted analyses confirmed a graded increase in CAD risk across distributions of all four obesity measures-1 standard deviation (SD) increase in BMI, waist, waist/height and waist/height(2) increased the odds of CAD by 1.23, 1.24, 1.26 and 1.27, respectively (all p<0.001). In models fully adjusted for CV risk factors, waist/height(2) remained the strongest obesity correlate of CAD, being the only independent associate of CAD in men. In a fully adjusted BMI-waist circumference stratified model, sarcopenic obesity (waist > median, BMI < median) and simple obesity (waist and BMI > median) were the strongest independent associates of CAD in men (p = 0.008) and women (p>0.001), respectively. CONCLUSION: This cross-sectional study showed that waist/height(2) may potentially offer a slightly higher predictive value of CAD than BMI or waist circumference and revealed an apparent sexual dimorphism in correlations between obesity measures and CAD.

Hypotonia during amikacin administration in a patient treated with continuous ambulatory peritoneal dialysis.

In this report we present the history of a patient treated with continuous ambulatory peritoneal dialysis (CAPD) in whom episodes of hypotonia can be related to the administration of amikacin, an antibiotic from the aminoglycosides group. The 68-year-old female patient was admitted for initiation of renal replacement therapy with CAPD. Her renal failure was probably attributable to hypertension. Three days after catheter implantation, the patient reported dysuric symptoms, and a urine culture showed significant growth of Escherichia coli. Amikacin 250 mg and cefazolin 1.0 g were administered intravenously once daily in accordance with the antibiogram. On the third day of antibiotic administration, the patient fainted, showing an arterial blood pressure of 90/60 mmHg. On the subsequent 2 days, decreases of postural arterial blood pressure to between 90/60 mmHg and 80/50 mmHg were reported two or three times daily. The patient was treated with antibiotics for the next 6 days and felt very bad the entire time, with an arterial blood pressure of 80/50 mmHg. The patient's condition improved 2 days after discontinuation of treatment with antibiotics, and episodes of hypotonia stopped. The decrease in the arterial blood pressure observed in our patient during intravenous administration of amikacin can, with a high probability, be related to the calcimimetic activity of this aminoglycoside and the resulting inhibition of parathyroid secretion.

Arterial distensibility, intima media thickness and pulse wave velocity after renal transplantation and in dialysis normotensive patients.

AIM: Structural and mechanical properties of the arterial wall are altered in patients with renal failure. The ageing process of the arterial wall appears to be accelerated in patients with end-stage renal failure. The mechanisms responsible for reduced arterial compliance and distensibility in dialysis patients and renal transplant recipients without hypertension remain to be evaluated. METHODS: Thirty-five normotensive dialysis patients (D), 35 normotensive renal transplant recipients (T) and 35 healthy volunteers (N) matched for age, sex and blood pressure as controls were enrolled into the study. The arterial blood pressure of all patients was < 140/90 mmHg. The dialysis patients and renal transplant recipients were eligible for the study if the serum creatinine level was < 2 mg/dL. In all subjects, fasting concentrations of serum creatinine, total cholesterol, HDL-cholesterol, LDL-cholesterol and hemoglobin and glucose were determined at enrollment to the study. Blood pressure was measured using an automatic sphygmomanometer. Pulse wave velocity (PWV) was evaluated using non invasive automatic Complior device. The vessel wall properties of the left common carotid artery were studied using multigate pulsed Doppler system. With this method, the end-diastolic diameter (d) and the systolic increase of vessel diameter (distension DELTAd) were measured. From these data the relative systolic increase of vessel diameter (DELTAd/d) and the arterial wall distensibility coefficient (DC) were calculated. RESULTS: Systolic blood pressure (SBP) and central pulse pressure (CPP) were significantly higher in T than in D and N group, respectively 138 +/- 18 mmHg and 59 +/- 16 mmHg vs 128 +/- 13 mmHg and 49 +/- 12 mmHg and 132.12 mmHg and 51 +/- 10 mmHg. The d did not change significantly between all groups. The distension DELTAd was significantly lower in patients group D and T, respectively 466 +/- 38 microm and 511 +/- 37 microm than in controls. Similarly DELTAd/d was in these groups significantly lower than in healthy volunteers, respectively D 6.33 +/- 0.5%, T 6.9 +/- 0.4% vs N 9.15 +/- 0.5%. DC was also significantly lower in D and T than in N groups, respectively D 17.91 +/- 1.5 10-3/kPa and T 18.92 +/- 1.3 10-3/kPa and N 24.28 +/- 0.51-3/kPa. Significant differences were found in the increase of the intima-media thickness (IMT) of carotid artery for dialyzed patients and renal transplant recipients in contrast to the control group, but there were no differences between the patients. PWV in both patient groups was statistically significant higher than in control group correspondingly D 11.1 +/- 1.03 m/s and T 13.3 +/- 1.13 m/s, N 9.4 +/- 0.89 m/s. There was a significant correlation between the change of DC, PWV and CPP in T group (n = 35; r = -0.43; P < 0.01 and n = 35; r = 0.48; P < 0.05). In the T group also an important correlation between PWV and IMT complex (n = 35; r = 0.49, P < 0.001) was found. CONCLUSIONS: The elastic and structural properties of arterial wall in dialysis patients and renal recipients are decreased. End-stage renal disease accelerates arterial stiffening despite of arteriosclerosis and hypertension. Renal transplantation does not reverse loss of elastic and morphologic properties of arteries found in patients with end-stage renal insufficiency.

Pulse pressure responses in patients treated with Valsartan and hydrochlorothiazide combination therapy.

In a randomized, double-blind, parallel-group study of middle-aged and elderly patients, we examined the effects of treatment with the angiotensin receptor blocker valsartan (Val) in combination with hydrochlorothiazide (HCTZ) on pulse pressure (PP). After a 2-week washout period, patients entered a 4-week single-blind Val 160 mg once daily run-in period before randomization to one of three treatment groups: Val 160 mg (n = 666), Val 160 mg/HCTZ 12.5 mg (n = 670) or Val 160 mg/HCTZ 25 mg (n = 666), once daily for eight weeks. Sitting PP at baseline was similar in all groups. From baseline to randomization, Val monotherapy reduced PP by 4.7 +/- 10.2 mmHg (mean +/- SD). At the end of the study, overall reductions in PP were 6.7 mmHg for Val 160/HCTZ 12.5 and 7.5 mmHg for Val 160/HCTZ 25. Val monotherapy reduced PP in mild-to-moderate hypertensive patients. Val combined with HCTZ provides an additional dose-related reduction in PP.

[Insulin binding to erythrocyte receptors in patients with essential hypertension]. / Wiazanie insuliny przez receptory insulinowe erytrocytów chorych na nadcisnienie tetnicze pierwotne.

Recently many researchers have described the presence of insulin resistance and hyperinsulinemia in a substantial number of patients with essential hypertension. Reduced insulin binding to the receptors may play important role in development of insulin resistance in these patients. The study was aimed to assess the value of insulin binding to erythrocyte receptors in the patients with essential hypertension and compare to values in healthy persons. Additional purpose was the evaluation of insulin degradation by erythrocytes in patients with essential hypertension. 23 patients with essential hypertension (BMI 22.7 +/- 3.2) and 21 healthy persons (with BMI value 23.3 +/- 2.9) were studied. In all examined individuals the blood glucose and blood insulin concentrations were determined, insulin binding to erythrocyte receptors and insulin degradation by erythrocytes were measured by the method of Gambhir and al. Insulin concentration was significantly higher in patients with essential hypertension than in healthy subjects. We demonstrated a statistically significant positive correlation between body weight and insulin concentration in blood serum only in healthy people. Insulin binding to the receptors of red blood cells was significantly stronger (p < 0.001) in healthy persons than in patients with essential hypertension (0.972 +/- 0.395 pg 10(11) RBC and 0.446 +/- 0.14 pg 10(11) RBC respectively). In patients with hypertension insulin binding to receptors of red blood cells does not depend on body weight and insulin concentration in blood serum. Values of insulin degradation by erythrocyte in patients with essential hypertension and healthy persons were not significantly different. It seems that decreased insulin binding to insulin receptors is an important mechanism of insulin resistance patients with essential hypertension.

Twenty-four hour ambulatory blood pressure monitoring in young and elderly hypertensive subjects.

The aim of our study was to compare blood pressure (BP) measured by 24-h ambulatory monitoring in young and elderly hypertensives and to find a dependency between left ventricular mass (LVM) and different pressure ratios. We also estimated the calcium ionized concentration and serum lipids in all subjects. Two hypertensive groups divided accordingly by age were studied. The duration of hypertension was similar in both groups. The Oxford Medilog ABP was used for the arterial BP recordings. Mean arterial BP, BP loads and night/day mean arterial pressure ratio were evaluated. In both groups left ventricular mass index (LVMI) were calculated. The serum calcium ionized concentration (Ca++) was estimated and serum lipids were determined. We found 10 non-dippers in the young group and seven non-dippers in the elderly hypertensives. LVM and LVMI were comparable in both groups. We showed the correlation of the nocturnal mean arterial pressure with LVM in elderly hypertensives and the dependency of nocturnal BP load with LVM in this group. Serum calcium ionized concentration was significantly decreased in the elderly patients, and LDL-cholesterol was significantly higher in this group. We found a negative correlation between serum calcium and triglycerides in young and elderly hypertensives. We found more non-dippers in the young hypertensives and a positive correlation between LVM and nocturnal mean arterial pressure and nocturnal BP load in elderly subjects. These results suggest the cardiovascular prognosis is not good in both groups. The prognosis in elderly hypertensives was also worsened by the low serum calcium ionized and high LDL-cholesterol concentrations.

Acetylsalicylic acid (aspirin) test for the diagnosis of renovascular hypertension.

OBJECTIVE: To determine whether the administration of acetylsalicylic acid (ASA, also known as Aspirin) differentiates patients with renovascular hypertension from those with essential hypertension, in order to provide a simple alternative to more expensive forms of diagnosis for this condition. DESIGN: Trial of ASA test in patients with previously diagnosed essential and renovascular hypertension. SETTING: Inpatient department of an academic health sciences centre in Poznan, Poland. PATIENTS: Forty patients with essential hypertension and 21 patients with renovascular hypertension. INTERVENTIONS: Patients were given an intravenous injection of ASA (10 mg/kg body weight), blood pressure was measured and blood was sampled and assayed for plasma renin activity (PRA) before and 30 minutes after the injection. RESULTS: ASA infusion in patients with renovascular hypertension resulted in a decrease in PRA from 15.2 (standard deviation [SD] 12.4) ng/mL per hour to 7.2 (SD 9.8) ng/mL per hour, whereas in patients with essential hypertension the initial PRA was significantly lower before ASA administration and did not change afterward. In patients with renovascular hypertension, the mean systolic, diastolic and arterial pressure decreased significantly (p < 0.001) after ASA infusion, but these did not change in patients with essential hypertension. Based on the criterion of 4 mm Hg as a detectable decrease in mean blood pressure, the sensitivity of the ASA test was 95.0% and the specificity 82.5%; its positive predictive value was 74% and its negative predictive value 97%. CONCLUSION: The precise measurement of blood pressure during the ASA test may provide a useful method of differentiating between patients with renovascular and essential hypertension.

[Clinical characteristics of patients with hypertension resistant to antihypertensive drug therapy]. / Charakterystyka kliniczna chorych z nadcisnieniem tetniczym opornym na leczenie hipotensyjne.

Two groups of hypertensive patients: 137 responsive (on one or two drugs) and 162 resistant on antihypertensive treatment in the similar age were compared. Resistant patients (on three or more drugs) characterize by significantly higher body weight and BMI, longer history of hypertension, more frequent hypertension prevalance in family members and lower education. Level of triglycerides in resistant on antihypertensive treatment patients was significantly higher than in responsive patients. Insulin level in blood in 31 patients with essential hypertension was significantly higher than in 36 healthy persons and 20 patients with renovascular hypertension and resistant on antihypertensive therapy. In 14 patients with essential hypertension resistant to treatment insulin level one hour after oral glucose load was significantly (p < 0.01) higher than in 16 patients with essential hypertension responsive to antihypertensive treatment.

[Activity of pyrimidine 5'nucleotidase (py5'Nd) of erythrocytes in essential hypertension]. / Aktywnosc nukleotydazy 5'pirymidynowej (Py5'Nd) krwinek czerwonych w nadcisnieniu tetniczym pierwotnym.

Activity of pyrimidine 5'nucleotidase was measured in hemolysate of erythrocytes of healthy persons and patients with essential hypertension. Cytidine 5'monophosphate (CMP) and uridine 5'monophosphate (UMP) were used as the substrates for evaluation of activity of so called I-isoenzyme and uridine 3'monophosphate (U3'MP) was used as a substrate for the II isoenzyme of Py5'Nd. It was found that the activity of Py5'Nd I was lower in hypertensives (26.8 mU/gHb (CMP)) and 69.3 mU/gHb (UMP) in comparison with normotensives (62.3 and 117.4 mU/gHb respectively) (p < 0.05). The activity of Py5'Nd II did not differ between studied groups. Possible metabolic consequences of decreased activity of Py5'Nd are discussed.

[Effect of nifedipine on proximal tubular function in patients with essential hypertension]. / Wplyw nifedypiny na funkcje cewki proksymalnej u chorych z nadcisnieniem tetniczym.

The effect of a single 20 mg sublingual dose of nifedipine on function of proximal tubule of nephron in patients with essential hypertension was studied by measuring changes in renal excretion of water, sodium, uric acid and beta-2-microglobulin (B2m) after nifedipine administration. Fifteen patients at the mean age of 40.1 +/- 7 years, with mild to moderate essential hypertension were studied. Systolic (SBP) and diastolic (DBP) blood pressure as well as heart rate (HR) were recorded every hour. Urine was sampled over 60-min, four times. The first two periods were regarded controls and the last two periods followed the administration of a 20 mg sublingual nifedipine dose. Blood samples were taken 1 h before and 1 h after that. Sodium, uric acid, B2m and creatinine in urine and plasma were determined. Nifedipine caused a significant fall in SBP and DBP (p < 0.001) and a marked increase in HR (p < 0.001). Diuresis, sodium (CNa) and uric acid (Cua) clearances were significantly increased (p < 0.001). Similarly, fractional excretion of sodium (FENa) was higher (p < 0.01). B2m excretion (UB2m) showed a two fold increase after nifedipine administration (p < 0.01). A positive correlations were found between the changes in CNa and Cua (r = 0.835, p < 0.001) and between the changes in UB2m and CNa (r = 0.747, p < 0.001). The results indicate that nifedipine induces an increase in diuresis, natriuresis and excretion of uric acid and B2m. These findings and the relationship between the changes in UB2m and Cua proves effect of nifedipine on proximal tubular function.

Percutaneous transluminal renal angioplasty in the management of hypertension and renal failure in patients with renal artery stenosis.

Percutaneous transluminal renal angioplasty (PTRA) is an accepted method of treatment of hypertension resulting from renal artery stenosis. There is less information on the role of PTRA in patients with renal artery disease and renal impairment. We report on 30 patients who underwent PTRA for renal artery stenosis (13 had uncontrolled hypertension and normal renal function and 17 had hypertension and renal insufficiency; 26 patients had atheromatous disease, fibromuscular dysplasia was diagnosed in 2 and 2 patients had renal artery stenosis to a transplant kidney). These 30 patients had 43 PTRA procedures, with the 'initial technical success' rate of 81% and the 'overall success' rate of 79% after ten months. Results of renal PTRA on BP showed the initial benefit in 88% of patients: 71% 'cured' and 17% 'improved'. After ten months only 38% of patients could still be considered 'cured' and 33% 'improved'. Renal function 'improved' in 68% of patients who presented with renal insufficiency. An improvement of BP control or renal function was less likely in patients with bilateral severe atheromatous disease. PTRA is an effective treatment for renal artery stenosis. Satisfactory improvement of BP control and improvement or prevention of further deterioration of renal function may be achieved in a high proportion of patients.

[Evaluation of uric acid transport in nephrons of patients with calcium nephrolithiasis and hyperuricosuria]. / Ocena transportu kwasu moczowego w nefronie u chorych z wapniowa kamica nerkowa i hiperurykozuria.

Renal excretion of uric acid was studied in 48 patients with recurrent calcium nephrolithiasis. Hyperuricosuria was found in 16 patients (33%) and among them 10 patients had increased values of urate clearance and fractional excretion. The tubular transport of urate was evaluated by means of pharmacological tests with pyrazinamide (PZA) and benzbromarone (BB) in these 11 patients with hyperuricosuria of renal origin. PZA suppression test was normal in 10 patients while in one case uric acid excretion was not suppressed sufficiently by PZA. Maximal uricorusirc response to BB was increased in two patients, normal in one patient and impaired in eight patients. PZA and BB tests revealed isolated defect of uric acid postsecretory reabsorption in seven patients, impaired reabsorption at both pre- and postsecretory site in one case and enhanced tubular secretion of uric acid in two patients. This study indicates that different defects of uric acid transport in nephron are the frequent cause of hyperuricosuria in patients with recurrent calcium nephrolithiasis.

[Value of oxypurines and uric acid in plasma, renal excretion of oxypurines and uric acid as well as plasma adenosine deaminase and AMP deaminase activity in patients with essential hypertension]. / Stezenie oksypuryn i kwasu moczowego w osoczu krwi, nerkowe wydalanie oksypuryn i kwasu moczowego oraz aktywnosc dezaminazy adenozyny i dezaminazy AMP w surowicy krwi chorych na nadcisnienie tetnicze samoistne.

Serum uric acid and oxypurines (hypoxanthine and xanthine) renal excretion of uric acid and oxypurines as well as plasma adenosine deaminase activity and AMP deaminase activity were studied in 18 patients with essential hypertension and in 17 healthy subjects. The aim of the study was to evaluate uric acid production rate in essential hypertension. Serum uric acid was significantly higher (7.04 +/- 2.03 mg% = 370.5 +/- 106 mumol/l; p < 0.01) in essential hypertension in comparison with control group (5.2 +/- 1.0 mg% = 275.0 +/- 51.9 mumol/l) and plasma oxypurines were increased insignificantly. Impairment of fractional excretion of uric acid (p < 0.05) was found in patients with essential hypertension. Plasma adenosine deaminase activity and plasma AMP deaminase activity did not differ in the studied groups. Increased production of uric acid does not contribute the incidence of hyperuricemia in essential hypertension. The results suggest that tubular defect of oxypurines excretion similar to that of uric acid exists in patients with essential hypertension.

[Uric acid and arterial hypertension. I. Relation between serum uric acid level and its renal excretion in primary arterial hypertension]. / Kwas moczowy a nadcisnienie tetnicze. I. Zaleznosc pomiedzy stezeniem kwasu moczowego w surowicy a jego nerkowym wydalaniem w nadcisnieniu tetniczym pierwotnym.

In forty patients with mild to moderate essential hypertension and in twenty healthy subjects serum uric acid was measured and parameters of renal excretion of urate were evaluated. Serum uric acid concentration and prevalence of hyperuricemia were significantly higher in hypertensive patients. Patients with essential hypertension and concomitant hyperuricemia showed significantly decreased clearance and fractional excretion of uric acid in comparison with normotensive subjects. Adverse correlation between serum uric acid and clearance as well as fractional excretion of urate found in hypertensive patients indicates that high prevalence of hyperuricemia in essential hypertension is caused by impaired renal excretion of uric acid.

[Uric acid and arterial hypertension. II. Evaluation of uric acid transport in the nephrons in primary arterial hypertension]. / Kwas moczowy a nadcisnienie tetnicze. II. Ocena transportu kwasu moczowego w nefronie w nadcisnieniu tetniczym pierwotnym.

In forty patients with mild to moderate essential hypertension correlation between serum uric acid as well as renal excretion of urate and the transport of uric acid in nephron was evaluated. Quantity of the separate phases of uric acid transport in nephron was calculated based upon pharmacological tests with pyrazinamide and benzbromarone. The results obtained in twenty normotensive subjects were assumed to be a normal values. Positive correlation between serum uric acid and presecretory reabsorption of urate was found in hypertensive patients. However presecretory reabsorption of urate did not significantly differ between hypertensive patients with concomitant hyperuricemia and normotensive subjects. Tubular secretion of uric acid was significantly lower in hypertensive patients in comparison with normotensive subjects. Plasma uric acid correlated inversely++ with tubular secretion of urate in patients with essential hypertension. There was no difference in postsecretory reabsorption of uric acid between the groups. Plasma uric acid did not correlate with postsecretory reabsorption of urate in hypertensive patients. These findings suggest that decreased uric acid clearance in hypertension with concomitant hyperuricemia is connected with impaired tubular secretion of urate.