Plasma Aldosterone and Glomerular Filtration in Hypertensive Patients With Preserved Renal Function

There is increasing interest in the role of aldosterone in the pathophysiology of hypertension, cardiovascular disease and deteriorating renal function. The aim of this study was to investigate the relationship between aldosterone and the glomerular filtration rate (GFR) in hypertensive patients with preserved renal function. The study involved 186 consecutive hypertensive patients with a GFR >60 mL/min. The GFR was determined using the Modification of Diet in Renal Disease (MDRD) equation and the patients’ plasma aldosterone levels were measured. Patients with a GFR between 60–89 mL/min had a significantly higher plasma aldosterone level than those with a GFR >90 mL/min (20.02 ng/dL vs 15.3 ng/dL; P<.05). Multivariate analysis showed that the plasma aldosterone level was independently associated with the GFR (B=–7.36; P<.001). In hypertensive patients with preserved kidney function, the plasma aldosterone level was observed to increase as the GFR decreased.

Hay un interés creciente en el papel de la aldosterona en la fisiopatología de la hipertensión arterial, la enfermedad cardiovascular y el deterioro de la función renal. El objetivo de nuestro trabajo es analizar la relación entre la aldosterona y el filtrado glomerular (FG) en pacientes hipertensos con función renal conservada. Hemos estudiado a 186 pacientes hipertensos consecutivos con filtrado renal > 60 ml/min, a quienes se determinaron las concentraciones plasmáticas de aldosterona y el FG mediante la fórmula MDRD (Modification of Diet in Renal Disease). Los pacientes con FG de 60–89 ml/min presentaban concentraciones plasmáticas de aldosterona significativamente más elevadas que aquellos con FG > 90 ml/min (20,02 frente a 15,3 ng/dl; p < 0,05). En el análisis multivariable, la aldosterona plasmática se asoció independientemente con el FG (B = –7,36; p < 0,001). En los pacientes hipertensos con función renal conservada se observa un aumento de la aldosterona plasmática a medida que disminuye el FG.