Biomarkers of kidney injury in hypertension: conventional versus novel

Mironova, S.; Iudina, I.; Ionov, M.; Avdonina, Natalia; Емельянов, И. В.; Васильева, Е. Ю.; Звартау, Н. Э.; Конради, А.

doi:10.18705/1607-419x-2018-24-2-223-236

Cited by 4 publications

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“…Оценка функции почек по данным стандартных маркеров поражения почек (уровню креатинина крови, альбуминурии и СКФ, рассчитанной по уровню креатинина крови) и по данным уровня цистатина С уже проводилась нами ранее. По её данным было продемонстрировано, что расчет СКФ по формуле CKD-EPI с учетом уровня креатинина дает более точные результаты оценки функции почек, а формула MDRD занижает значения СКФ у лиц без ХБП и в настоящее время рекомендуется в качестве скринингового метода оценки СКФ, а определение цистатина С в сыворотке крови для расчета СКФ предлагается использовать при уже существующем поражении почек или когда применение креатинина для оценки фильтрации имеет ограничения [11].…”

Section: Discussionunclassified

“…Согласно ранее проведенному нами исследованию уровень L-FABP в моче оказался единственным из исследуемых показателей, отражающим прогрессирование тубулоинтерстициального повреждения почек вследствие повышения уровня АД [11]. Результаты настоящего исследования также показали нарастание концентрации данного маркера с увеличением степени тяжести АГ по данным центрального аортального давления, являющегося прогностически более значимым по сравнению с периферическим, кроме того, были получены результаты взаимосвязи данного маркера со значениями системной сосудистой жесткости, что отмечалось у пациентов как с умеренной АГ так и с РАГ.…”

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Novel biomarkers of kidney injury and fibrosis in patients with different severity of hypertension: relation to vascular reactivity and stiffness

Mironova¹,

Iudina²,

Ionov³

et al. 2019

Russ J Cardiol

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Aim. To compare the relationships between conventional and new potentially more early investigational biomarkers (urine and ultrasound) of kidney injury and central aortic blood pressure, vascular stiffness and reactivity, endothelial dysfunction in patients with different severity of hypertension.Material and methods. Urine levels NGAL, KIM-1, L-FABP, albuminuria and serum levels of сystatin C and creatinine were measured in 92 hypertensive patients with mild and severe hypertension, 46 male (mean age 50,7±12,2 years). Glomerular filtration rate was estimated by the level of serum creatinine and cystatin C by MDRD and CKD-EPI formulas. Instrumental examination included measuring office blood pressure, 24-hour ambulatory blood pressure monitoring (SpaceLabs 90207), applanation tonometry (SphygmoCor, Artcor Medical) with the calculation of central aortic blood pressure, pulse wave velocity and augmentation index and Doppler ultrasonography with assessment of intraparenchymal renal arterial resistance indices — resistive index and pulsatility index (Vivid 7 dimension). Endothelial function was assessed by reactive hyperemia index with EndoPAT device (Itamar Medicals).Results. There were no differences in conventional levels of biomarkers between patients, however, cystatin C level increased and serum cystatin C estimated GFR and serum creatinine and cystatin C estimated GFR (CKD EPI formula) (sCr,Cys-estimated GFR) levels decreased with the severity of hypertension. These novel biomarkers were associated with increased central aortic blood pressure, arterial stiffness and intraparenchymal renal arterial resistance indices. Decreased sCr,Cys-estimated GFR levels were associated with lower reactive hyperemia index. There were no differences in NGAL, KIM-1 and L-FABP levels in patients with hypertension. However, NGAL levels were associated with increased augmentation index, resistive index in intralobular and pulsatility index in arcuate arteries, KIM-1 and L-FABP levels were associated with increased systolic and diastolic central aortic blood pressure, pulse wave velocity only in patients with severe and resistant hypertension.Conclusion. Serum cystatin C, NGAL, KIM-1 and L-FABP levels seem to be biomarkers of increased systemic and intrarenal vascular stiffness in patients with different severity of hypertension.

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Section: Discussionunclassified

Novel biomarkers of kidney injury and fibrosis in patients with different severity of hypertension: relation to vascular reactivity and stiffness

Mironova¹,

Iudina²,

Ionov³

et al. 2019

Russ J Cardiol

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Significance of modern diagnostic methods in the early diagnosis of hypertensive nephropathy

Осипова

Мельникова

2022

Cardiovasc Ther Prev

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The review analyzes modern criteria for early diagnosis of renal damage in hypertensive patients. Based on numerous studies, the role of impaired renal function markers and renal artery Doppler ultrasound in the diagnosis of hypertensive nephropathy is indicated. A search was made for the relationship between laboratory criteria for kidney damage and renal Doppler ultrasound characteristics in hypertensive patients. In addition, the importance of revealing intrarenal hemodynamic disorders in the early diagnosis of hypertensive nephropathy was established.

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Early identification of tubulointerstitial renal injury in hypertensive patients: a comparative evaluation of the urine biomarkers NGAL and KIM 1

et al. 2019

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Objective. The aim of the study was a comparative assessment of urine NGAL (neutrophil gelatinase associated lipocalin) and KIM‑1 (kidney injury molecule‑1) as biomarkers of early detection of tubulointerstitial renal damage in patients with arterial hypertension (HTN) without concomitant diabetes mellitus and kidney disease.Design and methods. The study involved 52 patients of both sexes (17 man and 35 women, mean age 60,2 ± 6,54 years) hospitalized for aggravation of HTN 1–3 degrees, which were divided into 3 groups with glomerular filtration rate (GFR) > 90 ml/min/1,73 m 2 (n = 21), 60–90 ml/min/1,73 m 2 (n = 19) and < 60 ml/min/1,73 m 2 (n = 12). In a separate group, patients with albuminuria in the range 10–29 mg/g urine creatinine were isolated. The comparison group consisted of 15 normotensive individuals (6 men and 9 women, mean age 49,8 ± 9,68 years) with no obvious signs of renal, cardiovascular or other diseases. All patients and controls underwent examination, and albumin, NGAL (Human NGAL ELISA kit) and KIM‑1 (Human KIM‑1 Immunoassay ELISA) levels were assessed in the first morning urine portion.Results. In the group of patients with GFR 67,7 ± 4,92 ml/min/1,73 m 2 (mildly reduced kidney function) and in the group of patients with GFR 55,8 ± 4,44 ml/min/1,73 m 2 (renal dysfunction) urine NGAL level increased by 3,43 (р < 0,05) and 3,92 times (р < 0,05), respectively, as compared with the control group. The urine concentration of KIM‑1 increased by 2,06 times (р < 0,05) was observed only in patients with renal dysfunction. Based on the ROC analysis AUC for the urine NGAL level in patients with mildly reduced kidney function is 0,78 (95 % confidence interval, 95 %CI: 0,70–0,86; p < 0,001), specificity — 89,6 %, sensitivity — 66,7 %. Similar indicators for KIM‑1 are 0,72 (95 % CI: 0,64–0,80; p < 0,001), specificity — 85,3 %, sensitivity — 16,7 %. In the group of patients with mildly reduced kidney function the urine level of NGAL correlated with the HTN severity (r = 0,8944, р < 0,001) and its duration (r = 0,8953, р < 0,001).Conclusions. Urine NGAL as compared with KIM‑1 is a more sensitive biomarker, which indicates tubulointerstitial injury in HTN patients without diabetes mellitus and kidney diseases in the early stage of impairment renal function.

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Biomarkers of kidney injury in hypertension: conventional versus novel

Cited by 4 publications

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Novel biomarkers of kidney injury and fibrosis in patients with different severity of hypertension: relation to vascular reactivity and stiffness

Novel biomarkers of kidney injury and fibrosis in patients with different severity of hypertension: relation to vascular reactivity and stiffness

Significance of modern diagnostic methods in the early diagnosis of hypertensive nephropathy

Early identification of tubulointerstitial renal injury in hypertensive patients: a comparative evaluation of the urine biomarkers NGAL and KIM 1

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