Determination of urinary markers of proteolysis/fibrinolysis and fibroangiogenesis in the kidney in hypertensive patients

Abstract

Aim. To determine clinical significance of urinary biomarkers of proteolysis/fibrinolysis and fibroangiogenesis in essential hypertension (EH). Material and methods. Examination of the kidneys was made in 71 patients with EH degree 1-3. Renal function was assessed by 24-h albuminuria, calculated glomerular filtration rate (GFR) by Cockroft-Golt. Early signs of renal damage were microalbuminuria - MAU (diurnal albuminuria 30-300 mg/day), reduction of GFR ( 0.65) as shown by dopplerometry. ELISA examined urinary biomarkers of intercellular and cell-matrix interactions in the kidney in EH patients and healthy controls (n = 12). Results. MAU was detected in 54 (76%) of 71 EH patients, elevated RI > 0.65 - in 37 (52%) patients. Urinary biomarkers of proteolysis/fibrinolysis and fibroangiogenesis were higher in EH patients then in the controls. Urinary excretion of PAI-1, TGF-beta1, VEGF and collagen of type IV in EH patients with MAU was significantly higher than in patients with normoalbuminuria. A strong direct correlation between MAU and the rest above urinary biomarkers was found as well as between urinary excretion of collagen IV and RI. An inverse negative relationship was seen between RI and GFR. Conclusion. Renal impairment in EH patients is a progressive disorder. Each stage of this process has its own clinicodiagnostic markers. Urinary biomarkers of proteolysis/fibrinolysis and fibroangiogenesis in the kidney are informative for monitoring of early HNP.

Keywords

• arterial hypertension
• hypertensive nephropathy
• microalbuminuria
• resistance index
• inhibitor of type 1 plasminogen activator
• transforming growth factor beta1
• vascular endothelium growth factor
• collagen of type iv