The role of urinary renalase on early-stage renal damage in Chinese adults with primary hypertension

Abstract

It would be of great clinical value to find an indicator that can accurately evaluate the early-stage renal injury in primary hypertension. Previous findings have shown renalase not only plays an important role in hypertension but also closely correlates with kidney function. The purpose of this study is to investigate whether urinary renalase could be used as a predictive index of early-stage renal damage in patients with primary hypertension. Urinary albumin to creatinine ratio (UACR) was used to divide subjects with primary hypertension into two groups: a no renal damage (NRD) group (UACR <30 mg/g) and an early-stage renal damage (RD) group (UACR >30 mg/g). Subjects with normal examination results were randomly included in a healthy control (HC) group. Urinary renalase was determined through an enzyme-linked immunosorbent assay (ELISA). Urinary renalase continued to reduce among the HC (n = 81), NRD (n = 84) and RD group (n = 80), while systolic blood pressure (SBP) increased. Urinary renalase was negatively correlated with SBP in all the groups. Among the subjects with stage 1 primary hypertension, urinary renalase in the RD group was lower than the NRD group, while the UACR was higher, and urinary renalase was negatively correlated with the UACR. A multiple linear stepwise regression analysis showed that there was a linear regression relationship between the increase of the UACR and urinary renalase, heart rate (HR), SBP and serum creatinine. In addition, the standardized partial regression coefficient of urinary renalase was the highest. The performance of urinary renalase as a marker for the diagnosis of early-stage renal damage in patients with primary hypertension was 0.968 with a cut off value of 2.01 µg/ml. Taken together, urinary renalase was further decreased in patients with early-stage renal damage and primary hypertension, and consequently, it could be used as a predictive index. Impact statement In patients with early-stage kidney damage of primary hypertension, there are no obvious structural or functional changes, which leads to a high level of diagnostic omissions. Therefore, it would be of great clinical value to find an indicator that can accurately evaluate the early-stage renal injury in primary hypertension. Urinary albumin to creatinine ratio (UACR) is a classic indicator used in early-stage renal damage, but it is affected by many factors. Renalase, a protein discovered by Xu in 2005, not only plays an important role in hypertension but also closely correlates with kidney function. In our study, we found that urinary renalase was further decreased in patients with early-stage renal damage in primary hypertension, and it could be used as a predictive index. This finding could help to diagnose the early-stage renal damage in primary hypertension much earlier and improve the prognosis of these patients.

Association of renalase with clinical outcomes in hospitalized patients with COVID-19

“…Its secreted form promotes cell survival and downregulates the inflammatory response by signaling through the plasma-membrane calcium-ATPase ATP2B4, and activating growth and survival intracellular pathways (protein kinase B, JAK/STAT, and MAP kinase) [18]. In patients with acute renal, or cardiac injury low renalase has been associated with worse outcomes [19][20][21][22]. In animal models, renalase administration reduces cell injury through modulation of inflammation, preservation of vascular integrity via increase in nitric oxide, and preventing apoptosis [23][24][25][26][27].…”

Metabolomics of Artichoke Bud Extract in Spontaneously Hypertensive Rats

“…Chronic kidney disease is a significant risk factor for hypertension, − with results from animal models showing that kidneys from SHRs exhibit significant dysfunction . For SHR-associated renal transplanted rats, the genotype of the kidney of the donor rather than that of the recipient determined the blood pressure .…”

Effects of Ziyin Qianyang Formula on Renal Fibrosis through the TGF-β1/Smads Signaling Pathway in Spontaneously Hypertensive Rats

“…Early renal impairment in patients with EH is often not clinically evident and the symptoms usually appear only when the renal damage is in the middle-to-late stages [ 14 ]. Elevated systolic blood pressure and mean arterial pressure are also the most important risk factors for renal impairment in the elderly [ 15 ].…”