Serum soluble (pro)renin receptor level as a prognostic factor in patients undergoing maintenance hemodialysis

Abstract

The (pro)renin receptor [(P)RR)] is a multifunctional protein that is cleaved to generate the soluble (P)RR [s(P)RR], reflecting the status of the tissue renin-angiotensin system and/or activity of the (P)RR. The serum s(P)RR level is associated with arteriosclerosis, independent of other risk factors, in patients undergoing hemodialysis (HD). This study was conducted to investigate whether the s(P)RR level was associated with new-onset cardiovascular events or malignant diseases and poor prognosis in patients undergoing HD. Overall, 258 patients [70 (61–76) years, 146 males] undergoing maintenance HD were prospectively followed up for 60 months. We investigated the relationships between s(P)RR levels and new-onset cardiovascular events/ malignant diseases and mortality during the follow-up period using Cox proportional hazard analyses. The cumulative incidence of new-onset cardiovascular events (P = 0.009) and deaths (P < 0.001), but not of malignant diseases, was significantly greater in patients with higher serum s(P)RR level (≥ 29.8 ng/ml) than in those with lower s(P)RR level (< 29.8 ng/ml). A high serum s(P)RR level was independently correlated with cardiovascular mortality (95% CI 1.001–1.083, P = 0.046). The serum s(P)RR level was associated with cardiovascular events and mortality, thus qualifying as a biomarker for identifying patients requiring intensive care.

Soluble (Pro)renin Receptor Is Adversely Associated with Indices of Left Ventricular Structure and Function: The African-PREDICT Study

“…Previous observations have linked (P)RR polymorphisms to BP levels in Japanese men (mean age 61.1 ± 9.6 years) [ 43 ] and white men (mean age, 45.4 ± 14 years) [ 44 ], while in animals s(P)RR was positively associated with systolic BP [ 16 ]. Recently, Amari et al [ 45 ] showed that s(P)RR is associated with cardiovascular events and mortality, serving as a biomarker to identify patients that require intensive care. The study population was older, with a number of CVDs and undergoing hemodialysis [ 45 ].…”

“…Recently, Amari et al [ 45 ] showed that s(P)RR is associated with cardiovascular events and mortality, serving as a biomarker to identify patients that require intensive care. The study population was older, with a number of CVDs and undergoing hemodialysis [ 45 ]. Our study already points to the usefulness of s(P)RR as a biomarker even in a healthy, young population (aged 20–30 years) with no current or historic CVD.…”