Assessment of glomerular and tubulointerstitial apparatus state depending on the level of the natriuretic peptide in hypertension patients
https://doi.org/10.15829/1560-4071-2020-3-3712
Abstract
Aim. To assess the state of the glomerular and tubulointerstitial apparatus depending on the level of the N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with hypertension (HTN).
Material and methods. The study included 119 patients with stage I-II HTN (target organ damage classification). We determined the cystatin C level, glomerular filtration rate (GFF) using the CKD-EPI equation, neutrophil gelatinase‐associated lipocalin (NGAL) and NT-proBNP levels; echocardiography and sphygmoplethysmography was performed. In the first analysis, patients were divided into two groups depending on the NT-proBNP level. Group 1 (n=32) consisted of patients with NTproBNP level >125 pg/ml, group 2 (n=87) — with NT-proBNP level <125 pg/ml. Empirically, the NT-proBNP cutoff point (75 pg/ml) was found to assess the role of cystatin C. The first group included 41 patients with NT-proBNP level >75 pg/ml, the second group — 78 patients with NT-proBNP level <75 pg/ml.
Results. In the group 1 (NT-proBNP >125 pg/ml) the NGAL concentration was significantly higher than in the group 2: 2,50 [1,90;2,85] vs 1,30 [0,9;2,0] ng/ml, respectively (p=0,022). Patients in the groups did not significantly differ in the cystatin C levels and GFR (p=0,099 and p=0,090, respectively). When dividing patients according to the NT-proBNP cutoff point (75 pg/ml), the following data were obtained. The concentration of cystatin C in the first group with NT-proBNP >75 pg/ml was 1041,50 [995,00;1185,00] vs 964,30 [801,00;1090,00] ng/ml in the second group (p=0,034). Patients in the groups significantly differed in GFR (p=0,027). A correlation analysis revealed a moderate, direct relationship of NT-proBNP with cystatin C (r=0,32; p<0,005) and NGAL levels (r=0,36; p<0,05), as well as a moderate, inverse relationship with GFR (r=-0,35; p<0,005).
Conclusion. NT-proBNP determination can be used as an integrative risk stratification tool for glomerular and tubulointerstitial injury in HTN patients.
About the Author
A. I. Chernyavina
E.A. Wagner Perm State Medical University
Russian Federation
Perm
Russian Federation
Perm
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For citations:
Chernyavina A.I. Assessment of glomerular and tubulointerstitial apparatus state depending on the level of the natriuretic peptide in hypertension patients. Russian Journal of Cardiology. 2020;25(3):3712. https://doi.org/10.15829/1560-4071-2020-3-3712
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