Association of inflammatory and hematological indices with subclinical kidney damage in patients with hypertension

Aim. To study the association of inflammatory and hematological indices with subclinical kidney damage in patients with hypertension (HTN).

Material and methods. The study included 135 patients with grade 1-2 HTN and ineffective blood pressure control (≥140/90 mm Hg), with an average age of 51,53±6,88 years. Patients underwent a complete blood count with estimation of hematological indices (systemic inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio, and monocyte-to-high-density lipoprotein cholesterol ratio (MHR)). A blood biochemical test to determine high-sensitivity C-reactive protein and cystatin C, and estimate glomerular filtration rate (GFR) calculated based on creatinine and cystatin C using the CKD-EPI equation (2021) was performed. An enzyme-linked immunosorbent assay to determine serum concentrations of interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-alpha.

Results. In the study group, the estimated GFR was 85,37 (78,38-95,74) ml/min/1,73 m², and the proportion of patients with elevated cystatin C levels was 74,07%. Correlation analysis revealed a positive association between cystatin C and IL-6 (r=0,22; p=0,036) and MHR (r=0,23; p=0,008), while the estimated GFR was negatively associated with MHR (r=-0,27; p=0,02). In patients with HTN, blood cystatin C and creatinine levels were higher with MHR >0,5 (p=0,044 and p=0,013, respectively), according to cluster analysis. An increase in the hematological index MHR >0,5 in combination with two or three factors, such as smoking, HTN duration ≥4 years, and NLR >1,4, was associated with blood cystatin C levels above refe­rence values in 100% of the patients studied.

Conclusion. In patients with HTN, a positive association was found between cystatin C, IL-6, MHR. A negative association was found between the estimated GFR and MHR. An MHR greater than 0,5 may indicate subclinical kidney damage in patients with HTN. Further study of the role of nonspecific inflammatory markers, including hematological indices, in predicting kidney damage is needed to improve risk stratification in patients with HTN.

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