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The Role of Two Heart Biomarkers in IgA Nephropathy
Balázs Sági1,2, Tibor Vas1, Rita Jakabfi-Csepregi3,4
12nd. Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary.
Insights
Biomarkers like N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and carboxy-terminal telopeptide of collagen type I (CITP) may identify IgA nephropathy patients at high risk for heart failure and atherosclerotic disease.
Area of Science:
- Nephrology
- Cardiology
- Biomarker Discovery
Background:
- Cardiovascular mortality is a major concern in chronic kidney disease (CKD), particularly IgA nephropathy (IgAN).
- Assessing cardiovascular risk in IgAN patients requires identifying reliable biomarkers for early detection of heart and vessel changes.
- Arterial stiffness and cardiac function are key factors influencing outcomes in CKD patients.
Purpose of the Study:
- To investigate the utility of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and carboxy-terminal telopeptide of collagen type I (CITP) as biomarkers in IgAN patients.
- To correlate these biomarkers with indicators of cardiovascular health, including arterial stiffness and cardiac function.
- To differentiate biomarker levels based on chronic kidney disease (CKD) stage.
Main Methods:
- Cross-sectional study of 90 IgAN patients, categorized into CKD stages 1-2 and 3-5 based on estimated glomerular filtration rate (eGFR).
- Measurement of NT-proBNP (heart failure biomarker) and CITP (fibrosis marker).
- Assessment of arterial stiffness via carotid-femoral pulse wave velocity (cfPWV), central aortic systolic pressure, and routine echocardiography.
Main Results:
- Patients in the CKD 3-5 group exhibited significantly higher NT-proBNP, cfPWV, and central aortic systolic pressure compared to the CKD 1-2 group.
- Both NT-proBNP and CITP positivity rates were significantly higher in the advanced CKD group.
- eGFR showed a strong negative correlation with NT-proBNP, while cfPWV and LVMI positively correlated with both NT-proBNP and CITP.
Conclusions:
- NT-proBNP and CITP show potential as biomarkers for identifying IgAN patients at high risk of subclinical heart failure.
- These biomarkers may aid in detecting early atherosclerotic disease progression in IgAN patients.
- Further research can validate these findings for clinical risk stratification in IgAN.
Abstract:
Cardiovascular mortality is a leading cause of death in chronic kidney disease (CKD), as is IgA nephropathy (IgAN). The purpose of this study is to find different biomarkers to estimate the outcome of the disease, which is significantly influenced by the changes in vessels (characterized by arterial stiffness) and the heart. In our cross-sectional study, 90 patients with IgAN were examined. The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was measured as a heart failure biomarker by an automated immonoassay method, while the carboxy-terminal telopeptide of collagen type I (CITP) as a fibrosis marker was determined using ELISA kits. Arterial stiffness was determined by measuring carotid-femoral pulse wave velocity (cfPWV). Renal function and routine echocardiography examinations were performed as well. Based on eGFR, patients were separated into two categories, CKD 1-2 and CKD 3-5. There were significantly higher NT-proBNP (p = 0.035), cfPWV (p = 0.004), and central aortic systolic pressure (p = 0.037), but not CITP, in the CKD 3-5 group. Both biomarker positivities were significantly higher in the CKD 3-5 group (p = 0.035) compared to the CKD 1-2 group. The central aortic systolic pressure was significantly higher in the diastolic dysfunction group (p = 0.034), while the systolic blood pressure was not. eGFR and hemoglobin levels showed a strong negative correlation, while left ventricular mass index (LVMI), aortic pulse pressure, central aortic systolic pressure, and cfPWV showed a positive correlation with NT-proBNP. cfPWV, aortic pulse pressure, and LVMI showed a strong positive correlation with CITP. Only eGFR was an independent predictor of NT-proBNP by linear regression analysis. NT-proBNP and CITP biomarkers may help to identify IgAN patients at high risk for subclinical heart failure and further atherosclerotic disease.
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