Cystatin C, vascular biomarkers and measured glomerular filtration rate in patients with unresponsive hypertensive phenotype: a pilot study. (1st January 2017)

• Record Type: Journal Article
• Authors: Čabarkapa, Velibor; Ilinčić, Branislava; Đerić, Mirjana; Vučaj Ćirilović, Viktorija; Kresoja, Milena; Žeravica, Radmila; Sakač, Vladimir
• Is Part Of: Renal failure. Volume 39:Number 1(2017)
• Page Start: 203
• Page End: 210
• Publication Date: 2017-01-01
• Subjects: Biomarkers -- cystatin C -- subclinical tissue organ damage -- cardiovascular risk -- essential hypertension -- glomerular filtration rate; Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.1080/0886022X.2016.1256316
• Languages: English
• ISSNs: 0886-022X

Abstract

Abstract: Background: Biomarkers are commonly used to estimate the presence of subclinical cardiovascular disease (CVD) in patients with essential arterial hypertension (HT). In addition to known association between cystatin C and glomerular filtration rate (GFR), elucidating the association between cystatin C and vascular biomarkers (intima-media thickness of common carotid arteries (CCIMT), carotid plaque and renal artery resistance index (RRI)) in patients with unresponsive hypertensive phenotype could be of significant clinical interest. Methods: Participants ( n = 200, median age 58 (52–64) years, 49% female) under treatment with antihypertensive drugs were stratified into two subgroups based on their blood pressure level as having responsive hypertension (RHT – compliant and responsive to treatment, n = 100), or nonresponsive (URHT – compliant but nonresponsive to treatment, n = 100). GFR was measured by isotopic (slope-intercept) method (99m Tc diethylene triamine penta-acetic acid – mGFR). Results: The URHT group had significantly higher median cystatin C serum concentration ( p = 0.02) and CCIMT ( p = 0.00) compared to the RHT group, with no significant difference in RRI ( p = 0.51) and mGFR among subgroups [69.9 ± 28.2 vs 76.74 ± 23.61 ml/min/1.73m 2, p = 0.27]. In the URHT group, cystatin C was found to be associated with CCIMT ( p = 0.02), hsCRP ( p = 0.01) and duration of HT ( p = 0.02), independently of mGFR and age. Independent predictors of URHT phenotype were CCIMT ( p = 0.02) and hsCRP ( p = 0.04). Conclusion: In addition to GFR, cystatin C serum concentration is positively and independently associated with CCIMT in patient with URHT phenotype and subclinical CVD. Prospective larger studies should further investigate the clinical importance of this relationship.