Novel biomarkers in patients with uncontrolled hypertension with and without kidney damage

Introduction Estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR) are insensitive biomarkers for early detection of hypertension-mediated organ damage (HMOD). In this nationwide cross-sectional study, we assessed potential biomarkers for early HMOD in healthy persons...

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Main Authors: Karl Marius Brobak, Lene V. Halvorsen, Hans Christian D. Aass, Camilla L. Søraas, Arleen Aune, Eirik Olsen, Ola Undrum Bergland, Stine Rognstad, Kjersti B. Blom, Jon Arne K. Birkeland, Aud Høieggen, Anne Cecilie K. Larstorp, Marit D. Solbu
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Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Blood Pressure
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Online Access:https://www.tandfonline.com/doi/10.1080/08037051.2024.2323980
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author Karl Marius Brobak
Lene V. Halvorsen
Hans Christian D. Aass
Camilla L. Søraas
Arleen Aune
Eirik Olsen
Ola Undrum Bergland
Stine Rognstad
Kjersti B. Blom
Jon Arne K. Birkeland
Aud Høieggen
Anne Cecilie K. Larstorp
Marit D. Solbu
author_facet Karl Marius Brobak
Lene V. Halvorsen
Hans Christian D. Aass
Camilla L. Søraas
Arleen Aune
Eirik Olsen
Ola Undrum Bergland
Stine Rognstad
Kjersti B. Blom
Jon Arne K. Birkeland
Aud Høieggen
Anne Cecilie K. Larstorp
Marit D. Solbu
author_sort Karl Marius Brobak
collection DOAJ
description Introduction Estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR) are insensitive biomarkers for early detection of hypertension-mediated organ damage (HMOD). In this nationwide cross-sectional study, we assessed potential biomarkers for early HMOD in healthy persons and patients with hypertension. We hypothesised that plasma levels of biomarkers: (1) are different between healthy controls and patients with hypertension, (2): can classify patients with hypertension according to the degree of hypertension severity.Design and methods Patients with hypertension prescribed ≥2 antihypertensive agents were selected from a multicentre study. Healthy controls were selected from an ongoing study of living kidney donor candidates. Uncontrolled hypertension was defined as systolic daytime ambulatory blood pressure ≥135 mmHg. Kidney HMOD was defined by ACR > 3.0 mg/mmol or eGFR < 60 mL/min/1.73 m2. Patients with hypertension were categorised into three groups: (1) controlled hypertension; (2) uncontrolled hypertension without kidney HMOD; (3) uncontrolled hypertension with kidney HMOD. Fifteen biomarkers were analysed using a Luminex bead-based immunoassay, and nine fell within the specified analytical range.Results Plasma levels of Interleukin 1 receptor antagonist (IL-1RA), neutrophil gelatinase-associated lipocalin (NGAL) and uromodulin were significantly different between healthy controls (n = 39) and patients with hypertension (n = 176). In regression models, with controlled hypertension (n = 55) as the reference category, none of the biomarkers were associated with uncontrolled hypertension without (n = 59) and with (n = 62) kidney HMOD. In models adjusted for cardiovascular risk factors and eGFR, osteopontin (OPN) was associated with uncontrolled hypertension without kidney HMOD (odds ratio (OR) 1.77 (1.05–2.98), p = 0.03), and regulated upon activation normal T-cell expressed and secreted (RANTES) with uncontrolled hypertension with kidney HMOD (OR 0.57 (0.34–0.95), p = 0.03).Conclusions None of the biomarkers could differentiate our hypertension groups when established risk factors were considered. Plasma OPN may identify patients with uncontrolled hypertension at risk for kidney HMOD.
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spelling doaj-art-0ffb2fdb14a74c66a8326310940cb73c2025-08-20T02:08:38ZengTaylor & Francis GroupBlood Pressure0803-70511651-19992024-12-0133110.1080/08037051.2024.2323980Novel biomarkers in patients with uncontrolled hypertension with and without kidney damageKarl Marius Brobak0Lene V. Halvorsen1Hans Christian D. Aass2Camilla L. Søraas3Arleen Aune4Eirik Olsen5Ola Undrum Bergland6Stine Rognstad7Kjersti B. Blom8Jon Arne K. Birkeland9Aud Høieggen10Anne Cecilie K. Larstorp11Marit D. Solbu12Section of Nephrology, University Hospital of North Norway, Tromsø, NorwayDepartment of Nephrology, Oslo University Hospital Ullevål, Oslo, NorwayDepartment of Medical Biochemistry, Oslo University Hospital Ullevål, Oslo, NorwaySection for Cardiovascular and Renal Research, Oslo University Hospital Ullevål, Oslo, NorwayDepartment of Heart Disease, Haukeland University Hospital, Bergen, NorwayClinic of Emergency Medicine and Prehospital Care, Trondheim University Hospital, Trondheim, NorwaySection for Cardiovascular and Renal Research, Oslo University Hospital Ullevål, Oslo, NorwayInstitute of Clinical Medicine, University of Oslo, Oslo, NorwayDepartment of Nephrology, Oslo University Hospital Ullevål, Oslo, NorwayDepartment of Nephrology, Oslo University Hospital Ullevål, Oslo, NorwayDepartment of Nephrology, Oslo University Hospital Ullevål, Oslo, NorwayInstitute of Clinical Medicine, University of Oslo, Oslo, NorwaySection of Nephrology, University Hospital of North Norway, Tromsø, NorwayIntroduction Estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR) are insensitive biomarkers for early detection of hypertension-mediated organ damage (HMOD). In this nationwide cross-sectional study, we assessed potential biomarkers for early HMOD in healthy persons and patients with hypertension. We hypothesised that plasma levels of biomarkers: (1) are different between healthy controls and patients with hypertension, (2): can classify patients with hypertension according to the degree of hypertension severity.Design and methods Patients with hypertension prescribed ≥2 antihypertensive agents were selected from a multicentre study. Healthy controls were selected from an ongoing study of living kidney donor candidates. Uncontrolled hypertension was defined as systolic daytime ambulatory blood pressure ≥135 mmHg. Kidney HMOD was defined by ACR > 3.0 mg/mmol or eGFR < 60 mL/min/1.73 m2. Patients with hypertension were categorised into three groups: (1) controlled hypertension; (2) uncontrolled hypertension without kidney HMOD; (3) uncontrolled hypertension with kidney HMOD. Fifteen biomarkers were analysed using a Luminex bead-based immunoassay, and nine fell within the specified analytical range.Results Plasma levels of Interleukin 1 receptor antagonist (IL-1RA), neutrophil gelatinase-associated lipocalin (NGAL) and uromodulin were significantly different between healthy controls (n = 39) and patients with hypertension (n = 176). In regression models, with controlled hypertension (n = 55) as the reference category, none of the biomarkers were associated with uncontrolled hypertension without (n = 59) and with (n = 62) kidney HMOD. In models adjusted for cardiovascular risk factors and eGFR, osteopontin (OPN) was associated with uncontrolled hypertension without kidney HMOD (odds ratio (OR) 1.77 (1.05–2.98), p = 0.03), and regulated upon activation normal T-cell expressed and secreted (RANTES) with uncontrolled hypertension with kidney HMOD (OR 0.57 (0.34–0.95), p = 0.03).Conclusions None of the biomarkers could differentiate our hypertension groups when established risk factors were considered. Plasma OPN may identify patients with uncontrolled hypertension at risk for kidney HMOD.https://www.tandfonline.com/doi/10.1080/08037051.2024.2323980Hypertensionhypertension-mediated organ damage (HMOD)kidney damageinflammationfibrosis
spellingShingle Karl Marius Brobak
Lene V. Halvorsen
Hans Christian D. Aass
Camilla L. Søraas
Arleen Aune
Eirik Olsen
Ola Undrum Bergland
Stine Rognstad
Kjersti B. Blom
Jon Arne K. Birkeland
Aud Høieggen
Anne Cecilie K. Larstorp
Marit D. Solbu
Novel biomarkers in patients with uncontrolled hypertension with and without kidney damage
Blood Pressure
Hypertension
hypertension-mediated organ damage (HMOD)
kidney damage
inflammation
fibrosis
title Novel biomarkers in patients with uncontrolled hypertension with and without kidney damage
title_full Novel biomarkers in patients with uncontrolled hypertension with and without kidney damage
title_fullStr Novel biomarkers in patients with uncontrolled hypertension with and without kidney damage
title_full_unstemmed Novel biomarkers in patients with uncontrolled hypertension with and without kidney damage
title_short Novel biomarkers in patients with uncontrolled hypertension with and without kidney damage
title_sort novel biomarkers in patients with uncontrolled hypertension with and without kidney damage
topic Hypertension
hypertension-mediated organ damage (HMOD)
kidney damage
inflammation
fibrosis
url https://www.tandfonline.com/doi/10.1080/08037051.2024.2323980
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