URINARY BIOMARKERS IN EARLY VASCULAR REMODELING AND HYPERTENSION.

 

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https://storage.unitedwebnetwork.com/files/1099/eec9f4521f21ddf56559158c7211b322.pdf
URINARY BIOMARKERS IN EARLY VASCULAR REMODELING AND HYPERTENSION.

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Agne
Laucyte-Cibulskiene
Christopher Nilsson christopher.nilsson@med.lu.se Lund University Department of Clinical Sciences Malmö Malmö Sweden -
Gustav Lund gustav.lund@skane.se Lund University Department of Clinical Sciences Malmö Malmö Sweden -
Fong To fong.to@med.lu.se Lund University Department of Clinical Sciences, Cardiovascular Research—Matrix and Inflammation in Atherosclerosis Malmö Sweden -
Sofia Enhörning sofia.enhorning@med.lu.se Lund University Perinatal and Cardiovascular Epidemiology, Department of Clinical Sciences Malmö Malmö Sweden -
Anders Christensson anders.christensson@med.lu.se Lund University Department of Clinical Sciences Malmö Malmö Sweden -
Agne Laucyte-Cibulskiene agne.laucyte-cibulskiene@med.lu.se Lund University Department of Clinical Sciences Malmö Malmö Sweden *
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Chronic kidney disease (CKD) represents a unique phenotype characterized by accelerated vascular remodeling, contributing to both atherosclerosis and arteriosclerosis following vascular calcification. Early kidney damage—manifested as alterations in the glomerular filtration barrier—is difficult to detect. Albuminuria is a globally accepted method for early detection; however, other urinary proteins and peptides may also serve as early markers of cardiorenal syndrome and vascular remodeling.

Here, we hypothesize that urinary biomarkers are associated with central hemodynamics—systolic (cSBP) and diastolic (cDBP) pressure—and vascular remodeling, measured as carotid-femoral pulse wave velocity (cfPWV), in a diabetes-free, healthy population.

Subjects from the Malmö Offspring Study (MOS) cohort with available plasma creatinine, plasma cystatin C, and urinary samples were randomly selected for urine aliquots. The Human ProcartaPlex™ Kidney Toxicity Panel 1 (Luminex assay) was used to measure 11 protein targets in a single well (se the table below). The urinary albumin-to-creatinine ratio (UACR) was also determined. The urinary protein-to-creatinine ratio (protein/Cr) was used to account for variations in urine concentration. Additionally, individuals with hypertension (n = 34) were compared with non-hypertensive participants (n = 118). Hypertension was defined as peripheral blood pressure higher than 140/90 mmHg.


Protein Name

Abbreviation

Calbindin

Clusterin

Apolipoprotein J

Glutathione S-transferase A1

GSTA1

Interleukin-18

IL-18

Interferon-inducible protein 10

IP-10 / CXCL10

Kidney Injury Molecule-1

KIM-1 / TIM-1 / HAVCR1

Monocyte Chemoattractant Protein-1

MCP-1 / CCL2

Osteoactivin

GPNMB

Retinol-binding Protein 4

RBP4

Renin

Vascular Endothelial Growth Factor A

VEGF-A


A total of 152 individuals (mean age 41 ± 6 years; 42% female) were analyzed. cSBP was negatively correlated with the urinary IL-18/Cr ratio (r = –0.198, p = 0.046); this relationship was slightly stronger than that observed with UACR (r = 0.195, p = 0.046). Central diastolic blood pressure (cDBP) was positively associated with the urinary KIM-1/Cr ratio (r = 0.227, p = 0.025), but not with UACR. Urinary VEGF-A, RBP4, GSTA1, and Calbindin values were significantly associated with cSBP (rs = 0.234, p = 0.004; rs = 0.212, p = 0.010; rs = 0.225, p = 0.018; and rs = 0.184, p = 0.023, respectively). Urinary GSTA1 values were also correlated with cDBP (rs = 0.194, p = 0.042). No associations were found between cfPWV and any of the urinary proteins. Individuals with hypertension had higher urinary KIM-1/Cr levels (p = 0.047), but no differences in UACR.

This study supports the utility of urinary proteins beyond UACR as early indicators of changes in central hemodynamics and hypertension but not aortic stiffness. 

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