For a long time chronic kidney disease (CKD) in hypertensive patients has been an underdiagnosed condition, although this pathological state is a significant predictor of serious cardiovascular complications. The aim of study was to investigate the relationship between metabolic and proinflammatory markers and renal damage in hypertensive patients.Design and Method:
We examined 80 hypertensive nondiabetic patients. Renal function was analyzed through blood creatinine and glomerular filtration rate (GFR) (MDRD). Microalbuminuria (MAU), blood levels of citrulline, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, uric acid, glucose, insulin were measured. Blood pressure (BP) was obtained through ABPM.Results:
Participants were categorized into 2 groups: with GFR 90 ≥ and 60–89 ml/min/1.73 m2without MAU (Gr.1 pts) and those with MAU (stage 1–2 CKD) (Gr.2 pts). There was no difference between patients of two groups in BP, GFR, levels of creatinine, fibrinogen, uric acid, glucose and insulin (p > 0.05 in all cases). Serum citrulline and hs-CRP were significantly higher in Gr.2 pts than in Gr.1 pts: 113,6 ± 7,07 vs 92,2 ± 4,4 micromol/L (p < 0.01) and 4,35 ± 0,27 vs 3,50 ± 0,16 mg/L (p < 0.01) respectively. There was no association between GFR and inflammatory markers (uric acid and fibrinogen) and there was no association between GFR and glucose and insulin. But we stated a significant negative correlation between citrulline (r = −0.43, p < 0.01), hs-CRP (r = −0.32, p < 0.05) and GFR. Relationship between citrulline and hs-CRP and GFR may indicates an underlying tubulointerstitial dysfunction and low-grade chronic inflammation in mechanism of kidney damage at early stages of hypertensive nephropathy.Conclusions:
Hypertensive patients with early stages of renal damage have significantly higher levels of citrulline and hs-CRP than those without CKD. Our results suggest that citrulline may be an early biomarker of kidney injury in the beginning stages of CKD in hypertensive patients.