Novel biomarkers in patients with uncontrolled hypertension with and without kidney damage.

Autor:	Brobak KM; Section of Nephrology, University Hospital of North Norway, Tromsø, Norway.; Metabolic and Renal Research Group, UiT The Artic University of Norway, Tromsø, Norway., Halvorsen LV; Department of Nephrology, Oslo University Hospital Ullevål, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Section for Cardiovascular and Renal Research, Oslo University Hospital Ullevål, Oslo, Norway., Aass HCD; Department of Medical Biochemistry, Oslo University Hospital Ullevål, Oslo, Norway., Søraas CL; Section for Cardiovascular and Renal Research, Oslo University Hospital Ullevål, Oslo, Norway.; Section for Environmental and Occupational Medicine, Oslo University Hospital Ullevål, Oslo, Norway., Aune A; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Science, University of Bergen, Bergen, Norway., Olsen E; Clinic of Emergency Medicine and Prehospital Care, Trondheim University Hospital, Trondheim, Norway.; Department of Circulation and Medical Imaging, University of Trondheim, Trondheim, Norway., Bergland OU; Section for Cardiovascular and Renal Research, Oslo University Hospital Ullevål, Oslo, Norway., Rognstad S; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Section for Cardiovascular and Renal Research, Oslo University Hospital Ullevål, Oslo, Norway.; Department of Pharmacology, Oslo University Hospital Ullevål, Oslo, Norway., Blom KB; Department of Nephrology, Oslo University Hospital Ullevål, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Institute for Experimental Medical Research, and KG Jebsen Center for Cardiac Research, Oslo University Hospital, Ullevål and University of Oslo, Oslo, Norway., Birkeland JAK; Department of Nephrology, Oslo University Hospital Ullevål, Oslo, Norway., Høieggen A; Department of Nephrology, Oslo University Hospital Ullevål, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Section for Cardiovascular and Renal Research, Oslo University Hospital Ullevål, Oslo, Norway., Larstorp ACK; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Section for Cardiovascular and Renal Research, Oslo University Hospital Ullevål, Oslo, Norway.; Department of Medical Biochemistry, Oslo University Hospital Ullevål, Oslo, Norway., Solbu MD; Section of Nephrology, University Hospital of North Norway, Tromsø, Norway.; Metabolic and Renal Research Group, UiT The Artic University of Norway, Tromsø, Norway.
Jazyk:	angličtina
Zdroj:	Blood pressure [Blood Press] 2024 Dec; Vol. 33 (1), pp. 2323980. Date of Electronic Publication: 2024 Apr 12.
DOI:	10.1080/08037051.2024.2323980
Abstrakt:	Introduction: Estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR) are insensitive biomarkers for early detection of hypertension-mediated organ damage (HMOD). In this nationwide cross-sectional study, we assessed potential biomarkers for early HMOD in healthy persons and patients with hypertension. We hypothesised that plasma levels of biomarkers: (1) are different between healthy controls and patients with hypertension, (2): can classify patients with hypertension according to the degree of hypertension severity. Design and Methods: Patients with hypertension prescribed ≥2 antihypertensive agents were selected from a multicentre study. Healthy controls were selected from an ongoing study of living kidney donor candidates. Uncontrolled hypertension was defined as systolic daytime ambulatory blood pressure ≥135 mmHg. Kidney HMOD was defined by ACR > 3.0 mg/mmol or eGFR < 60 mL/min/1.73 m 2 . Patients with hypertension were categorised into three groups: (1) controlled hypertension; (2) uncontrolled hypertension without kidney HMOD; (3) uncontrolled hypertension with kidney HMOD. Fifteen biomarkers were analysed using a Luminex bead-based immunoassay, and nine fell within the specified analytical range. Results: Plasma levels of Interleukin 1 receptor antagonist (IL-1RA), neutrophil gelatinase-associated lipocalin (NGAL) and uromodulin were significantly different between healthy controls ( n  = 39) and patients with hypertension ( n  = 176). In regression models, with controlled hypertension ( n  = 55) as the reference category, none of the biomarkers were associated with uncontrolled hypertension without ( n  = 59) and with ( n  = 62) kidney HMOD. In models adjusted for cardiovascular risk factors and eGFR, osteopontin (OPN) was associated with uncontrolled hypertension without kidney HMOD (odds ratio (OR) 1.77 (1.05-2.98), p  = 0.03), and regulated upon activation normal T-cell expressed and secreted (RANTES) with uncontrolled hypertension with kidney HMOD (OR 0.57 (0.34-0.95), p  = 0.03). Conclusions: None of the biomarkers could differentiate our hypertension groups when established risk factors were considered. Plasma OPN may identify patients with uncontrolled hypertension at risk for kidney HMOD.
Databáze:	MEDLINE
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