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Phenotypes of acute renal function injuries in different acute high-altitude diseases



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Phenotypes of acute renal function injuries in different acute high-altitude diseases


YANG Weibo LI Suzhi GAO Yuqi HUANG Xuewen WANG Yuliang YANG Fan HUANG He SHI Quangui MOU Qingmei CHEN Xuemei

College of High Altitude Military Medicine, Army Medical University (Third Military Medical University),Chongqing, 400038; Center of High Altitude Medicine of PLA, Department of Clinical Laboratory, General Hospital of Tibet Military Command, Lhasa, Tibet Autonomous Region, 850007, China


acute high-altitude disease high-altitude pulmonary edema high-altitude cerebral edema acute kidney injury urea nitrogen creatinine uric acid


ObjectiveTo investigate the phenotypes of acute renal injuries in different types of acute highaltitude disease (AHAD). MethodsThis study was conducted among a total of 249 patients with AHAD admitted in the General Hospital of Tibetan Military Command, Lhasa (altitude of 3 680 m) in the years from 2016 to 2017 (case group), and 60 healthy volunteers with acute exposure to an altitude of 3 680 m served as the control group. In the case group, diagnoses of acute mountain sickness (AMS) were established in 44 patients, high altitude pulmonary edema (HAPE) in 121 patients and high altitude cerebral edema (HACE) in 84 patients. For all the participants, venous blood samples were drawn before treatment to test the renal function indexes including blood urea nitrogen (BUN), serum creatinine (Scr), cystatin C (CysC), uric acid (UA), creatinine clearance rate (Ccr) and carbon dioxide combining power (CO2CP). Urine red blood cell and white blood cell counts and urinary protein levels were tested by urine analysis, and the urine volume and pulse oxygen saturation (SpO2) were also recorded. ResultsThe patients with HAPE and HACE had significantly higher levels of BUN, Scr, CysC and UA than those with AMS and the control subjects (P<0.05), and these parameters did not differ significantly between the latter 2 groups (P>0.05). Compared with the patients with HAPE, the patients with HACE had significantly increased levels of BUN and Scr (P<0.05). Low counts of urine red blood cells and white blood cells were detected in both the case group and the control group, without significant differences between them (P>0.05). ConclusionThe severity of renal function injury varies among different types of AHAD. Renal function injury is common in patients with severe ADAH, and the functional impairment is often severer in HACE than in HAPE and is in the compensatory stage in most of the cases.


[1]HARHAY M N, HARHAY M O, COTOYGLESIAS F, et al. Altitude and regional gradients in chronic kidney disease prevalence in costa rica: data from the costa rican longevity and healthy aging study[J]. Trop Med Int Health, 2016, 21(1): 41-51. DOI: 10.1111/tmi.12622.
[2]余静, 杨定周, 孙泽平, 等. 不同方法治疗高原脑水肿的疗效及对肾功能的影响[J]. 西南国防医药, 2011, 21(5): 530-532. DOI: 10.3969/j.issn.1004 0188.2011.05.027.
YU J, YANG D Z, SUN Z P, et al. Therapeutic effects of three different methods on high altitude cerebral edema and their influences on renal function[J]. Med J Natl Defend Forc Southwest China, 2011, 21(5): 530-532. DOI: 10.3969/j.issn.10040188.2011.05.027.
[3]敖强国, 宋世涛, 邹慧. 高原低压低氧环境对平原健康男青年血象和肾功能影响[J]. 中华保健医学杂志, 2011, 13(6): 456-458. DOI: 10.3969/j.issn. 16743245.2011. 06.009.
AO Q G , SONG S T, ZOU H. Impact of hypoxia environment at plateau on renal function among healthy male youth[J]. Chin J Health Care Med, 2011, 13(6): 456-458. DOI: 10.3969/j.issn.16743245.2011.06.009.
[4]马全福, 袁延年, 罗莉, 等. 高原低氧应激对肾脏的影响[J]. 中华实验外科杂志, 2009, 26(8): 1057-1058. DOI: 10.3760/cma.j.issn.10019030.2009.08.039.
MA Q F, YUAN Y N, LUO L, et al. Stress damage of renal toleration when the organism exposed acutively at altitude hypoxia environment [J]. Chin J Exp Surg, 2009, 26(8): 1057-1058. DOI: 10.3760/cma.j.issn.10019030.2009.08.039.
[5]陈国柱, 覃军, 余洁, 等. 3 200米海拔步行5公里运动对急性高原病的影响研究[J]. 重庆医学, 2013, 42(30): 3593-3595, 3598. DOI: 10.3969/j.issn.16718348.2013.30.001.
CHEN G Z, QIN J, YU J, et al. Effects of five kilometers walking at 3 200 m high altitude on acute mountain sickness[J]. Chongqing Med J, 2013,42(30): 3593-3595, 3598. DOI: 10.3969/j.issn.16718348.2013.30.001.
[6]张建勇. 急性高原脑水肿的救治[J]. 中外健康文摘, 2010, 7(22): 36-37. DOI: 10.3969/j.issn.16725085.2010.22.025.
ZHANG J Y. Treatment of acute high altitude cerebral edema[J]. World Health Digest Med Period, 2010, 7(22): 36-37. DOI: 10.3969/j.issn.16725085.2010.22.025.
[7]宋桐林, 吴玉, 沈鹏宇, 等. 青年男性急性高原反应与地理因素的关系研究[J]. 局解手术学杂志, 2014,23(6): 599-602. DOI: 10.11659/jjssx.16725042.201406010.
SONG T L,WU Y,SHEN P Y,et al.Research on relationship between acute mountain sickness and geographic factors in young male[J]. J Region Anatomy Operat Surg,2014, 23(6): 599-602. DOI: 10.11659/jjssx.16725042.201406010.
[8]周国平. 急性肾损伤的诊断与治疗进展[J]. 中华实用儿科临床杂志, 2013,28(9): 717-720. DOI: 10.3760/cma.j.issn.2095428X.2013.09.023.
ZHOU G P. Progress in diagnosis and treatment of acute kidney injury[J]. J Appl Clin Pediatr, 2013, 28(9): 717-720. DOI: 10.3760/cma.j. issn.2095428X.2013.09.023.
[9]王琰, 努尔曼古丽, 王引虎, 等. 进驻不同海拔高原健康男青年肾功能的变化[J]. 西南国防医药, 2011, 21(1): 24-26. DOI: 10.3969/j.issn.10040188.2011.01.009.
WANG Y, NUERMANGULI, WANG Y H, et al.Changesofrenalfunctioninhealthyyoungmenarrivedatdifferenthighaltitudes[J]. Med J Natl Defend Forc Southwest China, 2011, 21(1): 24-26. DOI: 10.3969/j.issn.10040188.2011.01.009.
[10]石会兰, 郑振峰, 马慧, 等. 正常肾脏血氧依赖磁共振成像特点及与生理指标相关性研究[J]. 天津医药, 2014, 42(6): 619-621,630.DOI:10.3969/j.issn.02539896.2014.06.031.
SHI H L, ZHENG Z F, MA H, et al. Blood oxygen level dependent MRI of normal kidney and its correlation with physiological indexes[J]. Tianjin Med J, 2014,42(6): 619-621, 630. DOI: 10.3969/j.issn.02539896.2014.06.031.
[11]于忠浩, 刘春明, 李琳,等. 高选择性肾血管阻断对大鼠肾脏缺血再灌注损伤的影响[J]. 中国老年学, 2016, 36(1): 50-52. DOI: 10.3969/j.issn.1005 9202.2016.01.022.
YU Z H, LIU C M, LI L, et al. The effect of highly selective renal vascular occlusion on renal ischemia reperfusion injury in rats[J]. Chin J Gerontol, 2016, 36(1): 50-52. DOI: 10.3969/j.issn.10059202.2016.01.022.
[12]GOLDFARBRUMYANTZEV A S, ALPER S L.Shortterm responses of the kidney to high altitude in mountain climbers[J]. Nephrol Dial Transplant, 2014, 29(3): 497-506.DOI: 10.1093/ndt/gft051.
[13]CHEN W, LIU Q, WANG H, et al. Prevalence and risk factors of chronic kidney disease: a population study in the tibetan population[J]. Nephrol Dial Transplant, 2011, 26(5): 1592-1599. DOI:10.1093/ndt/gfq608.
[14]YIJIANG Z, JIANHUA Z, FEILI L. Acute kidney injury at high altitude[J]. High Alt Med Biol, 2013, 14(2): 183-185. DOI: 10.1089/ham.2012.1123.
[15]肖云, 沈漪萍, 王翠玉, 等. 尿素氮、肌酐、尿酸联合检测在妊娠期高血压疾病肾损害评估中的应用[J]. 安徽医药, 2016,20(5): 921-923. DOI: 10. 3969/j.issn.10096469.2016.05.028.
XIAO Y, SHEN Y P, WANG C Y, et al. Application of urea nitrogen, creatinine, uric acid combined detection in kidney damage assessment of pregnancyinduced hypertension[J]. Anhui Med Pharmaceuti J, 2016, 20(5): 921-923. DOI: 10.3969/j.issn.10096469.2016.05.028.
[16]张月娥.窒息新生儿血肌酐和血尿素氮水平变化及禁食时间对其影响[J]. 中华实用儿科临床杂志, 2012, 27(14): 1099-1100.
ZHANG Y E. Changes of serum creatinine and blood urea nitrogen levels in asphyxiated neonates and effects[J]. Chin J Appl Clin Pediatr, 2012, 27(14): 1099-1100.
[17]刘新龙, 苏美仙. 诊断早期急性肾损伤的新型标记物的研究进展[J]. 国际麻醉学与复苏杂志, 2013, 34(10): 932-935. DOI: 10.3760/cma.j.issn.16734378.2013.10.018.
LIU X L, SU M X. Research progress on the novel markers for early diagnosis of actue kidney injury[J]. Int J Anesthesiol Resuscit, 2013, 34(10): 932-935. DOI: 10.3760/cma.j.issn.16734378.2013.10.018.
[18]杨磊, 杨有利, 石自福, 等. 尿微量蛋白联合检测对高原短期暴露人群返回低海拔地区后肾脏脱适应损伤的判定[J]. 中华实用诊断与治疗杂志, 2014, 27(6): 572-573, 575. DOI: 10.13507/j.issn.16743474.2014.06.022.
YANG L, YANG Y L, SHI Z F, et al. Combined detection of urine microprotein in the diagnosis of kidney deadaptation injury in a population back to low altitude after a shortterm exposure to high altitude[J]. J Chin Pract Diagn Ther, 2014, 27(6): 572-573, 575. DOI: 10. 13507/j.issn.16743474.2014.06.022.
[19]ARESTEGUI A H, FUQUAY R, SIROTA J, et al. High altitude renal syndrome (HARS)[J].J Am Soc Nephrol, 2011, 22(11): 1963-1968. DOI: 10.1681/ASN.2010121316.


Last Update: 2018-07-03