Clinical value of urinary kidney biomarkers for estimation of renal impairment in elderly Chinese with essential hypertension

Abstract

The purpose of this work was to observe the excretion of specific types of urinary proteins and urinary enzymes in elderly essential hypertension patients, for early detection and targeted treatment of hypertensive nephropathy in the elderly. A total of 120 elderly essential hypertensive patients and 38 healthy elderly volunteers were involved. The urinary excretion rate of retinal-binding protein (RBP), transferrin (Tf), albumin (Alb), and urinary enzyme N-acetyl-beta-D-glucosaminidase (NAG) activity were determined. Patients were divided into two groups according to their creatinine clearance (Cockroft-Gault formula). There were 88 patients in group A, whose glomerular filtration rate (GFR) was Z80 mL/min, and 32 patients in group B with a GFR o80 mL/min. Among the essential hypertensive patients, urinary excretion rates of RBP, Alb, Tf, and NAG were increased in both groups compared with the healthy controls. But the amount of urinary protein differed between group A and group B. The excretion rate of specific urinary protein and urinary enzyme had a positive relationship with the duration of course of hypertension. We believe that specific types of urinary proteins and urinary enzymes may be useful markers for early diagnosis of hypertensive nephropathy; they can also be regarded as a clinical indicator of the progression of hypertensive nephropathy, serving in the assessment of therapeutic effects.

Acute kidney injury inChina

“…Relevant substances, such as neutrophil gelatinaseassociated lipocalin, liver-type fatty acid binding protein, cystatin C, kidney injury molecule-1, N-acetyl-beta-Dglucosaminidase, nestin, and interleukin-18 have all been well studied in the clinical setting in China. [38][39][40][41][42][43] In addition to those protein or peptide biomarkers, nucleic acids such as circulating microRNA have been added to the growing list of potentially useful biomarkers of AKI. 44 In a study involving 120 adult patients undergoing cardiac surgery, urinary and plasma microRNA-21(miR-21) were identified to be associated with severe AKI and other poor postoperative outcomes of cardiac surgery, indicating their potential use as prognostic markers.…”

“…A variety of promising biomarkers for AKI have been identified in the published literature. Relevant substances, such as neutrophil gelatinase‐associated lipocalin, liver‐type fatty acid binding protein, cystatin C, kidney injury molecule‐1, N‐acetyl‐beta‐D‐glucosaminidase, nestin, and interleukin‐18 have all been well studied in the clinical setting in China . In addition to those protein or peptide biomarkers, nucleic acids such as circulating microRNA have been added to the growing list of potentially useful biomarkers of AKI .…”