A set of urinary peptides can predict early renal damage in primary hypertension

作者全名："Lin, Lirong; Ren, Jiangwen; Wang, Chunxuan; Mei, Mei; Zheng, Luquan; Yang, Jurong"

作者地址："[Lin, Lirong; Wang, Chunxuan; Zheng, Luquan; Yang, Jurong] Chongqing Med Univ, Affiliated Hosp 3, Gener Hosp, Dept Nephrol, Chongqing 401120, Peoples R China; [Ren, Jiangwen] Jiulongpo Dist Peoples Hosp Chongqing, Dept Nephrol Rheumatism & Immunol, Chongqing, Peoples R China; [Mei, Mei] Chongqing Univ, Shapingba Hosp, Dept Nephrol, Chongqing, Peoples R China"

通信作者："Yang, JR (通讯作者)，Chongqing Med Univ, Affiliated Hosp 3, Gener Hosp, Dept Nephrol, Chongqing 401120, Peoples R China."

来源：JOURNAL OF HYPERTENSION

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001059165100018

JCR分区：Q1

影响因子：3.3

年份：2023

卷号：41

期号：10

开始页：1653

结束页：1660

文献类型：Article

关键词：chronic kidney disease; hypertension; hypertensive renal damage; urinary peptides

摘要："Objectives: Renal diseases caused by primary hypertension (HTN) are often asymptomatic without sensitive markers for early diagnosis and prediction, easily progressing to severe and irreversible renal damage in patients with clinical manifestations. This study explored whether a set of urinary peptides could serve as a potential biomarker for early prediction of renal damage in HTN. Methods: Urinary peptides level of healthy individuals, HTN+ normoalbuminuric and HTN+ albuminuria patients were compared, and 22 baseline data including sex, age, renal function, hypertensive fundus lesions were collected. Patients diagnosed with HTN, albuminuria, and normal renal function were followed up. According to the followup results, the cut-off value of a set of urinary peptides in predicting hypertensive renal injury was calculated and analyzed in the high-risk and low-risk groups of HTN patients for its performance in detecting early hypertensive renal injury. Results: Among a sum of 319 participants, average urinary peptides level was significantly higher in patients with HTN than in normal individuals. A total of 147 HTN patients with normal albuminuria were followed up for a mean of 3.8 years. Thirty-five patients showed urinary albumin-to-creatinine ratio (uACR) at least 30 mg/g for three consecutive times. The receiver-operating characteristic (ROC) curve showed that the urinary peptides cut-off value for evaluating new-onset proteinuria in patients with HTN was 0.097. Based on this cut-off value, 39 and 108 patients were included in the high-risk and low-risk groups, respectively. Specifically, compared with patients in the low-risk group, those in the high-risk group showed significantly longer duration of HTN, higher proportions of hypertensive fundus lesions and at least 30 mg/g uACR, and higher levels of homocysteine (Hcy), cystatin C (CysC), beta-2 microglobulin (beta 2-MG), and uACR. 76.9% of high-risk patients had significantly higher new-onset proteinuria than the low-risk group. Correlation analysis demonstrated a positive correlation between urinary peptides and UACR (r = 0.494, P< 0.001). The incidence of new-onset albuminuria was significantly higher in the high-risk group than in the low-risk group, as shown by Cox regression analysis. The areas under the curve of urinary peptides, Hcy, beta 2-MG and CysC were 0.925, 0.753, 0.796 and 0.769, respectively. Conclusion: A set of urinary peptides is a predictor of new-onset proteinuria in patients with HTN, therefore, it can be used for diagnosing patients with early renal injury in patients with HTN, contributing to early prevention and treatment of hypertensive nephropathy."

基金机构："National Natural Science Foundation of China [82270723, 81770682]; special project for technological innovation and application development of Chongqing [cstc2019jscx-msxmX0166]; Chongqing Talent Program Project [cstc2021ycjh-bgzxm0090]"

基金资助正文："This work was supported by the National Natural Science Foundation of China (No. 82270723, 81770682), The special project for technological innovation and application development of Chongqing (cstc2019jscx-msxmX0166), and the Chongqing Talent Program Project (cstc2021ycjh-bgzxm0090). WE thank Mr. En Liu and Mingjun Wu for clinical and technical help."