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Updated: Jun 28, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Novel biomarkers in patients with uncontrolled hypertension with and without kidney damage
Karl Marius Brobak1,2, Lene V Halvorsen3,4,5, Hans Christian D Aass6
1Section of Nephrology, University Hospital of North Norway, Tromsø, Norway.
Insights
New biomarkers may help detect hypertension-mediated organ damage (HMOD) earlier than current methods. Osteopontin (OPN) shows potential in identifying patients with uncontrolled hypertension at risk for kidney damage.
Area of Science:
- Nephrology
- Cardiology
- Biomarker Discovery
Background:
- Current biomarkers like eGFR and ACR are insufficient for early detection of hypertension-mediated organ damage (HMOD).
- Identifying novel biomarkers is crucial for managing hypertension and preventing end-organ damage.
Purpose of the Study:
- To investigate plasma biomarkers for early detection of HMOD in healthy individuals and hypertensive patients.
- To assess if these biomarkers can differentiate hypertension severity and predict kidney damage.
Main Methods:
- A nationwide cross-sectional study involving 176 hypertensive patients and 39 healthy controls.
- Analysis of 15 potential biomarkers using Luminex immunoassay, with a focus on Interleukin 1 receptor antagonist (IL-1RA), neutrophil gelatinase-associated lipocalin (NGAL), uromodulin, osteopontin (OPN), and RANTES.
- Hypertension groups were categorized into controlled, uncontrolled without kidney HMOD, and uncontrolled with kidney HMOD.
Main Results:
- Plasma IL-1RA, NGAL, and uromodulin levels differed significantly between healthy controls and hypertensive patients.
- Osteopontin (OPN) was associated with uncontrolled hypertension without kidney HMOD (OR 1.77).
- RANTES was associated with uncontrolled hypertension with kidney HMOD (OR 0.57), but none of the biomarkers reliably differentiated hypertension groups when established risk factors were considered.
Conclusions:
- Established biomarkers like eGFR and ACR are limited in detecting early HMOD.
- Plasma osteopontin (OPN) may serve as a potential biomarker to identify patients with uncontrolled hypertension at risk for kidney HMOD.
- Further research is needed to validate these findings and explore their clinical utility in hypertension management.
Introduction:
Estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR) are insensitive biomarkers for early detection of hypertension-mediated organ damage (HMOD). In this nationwide cross-sectional study, we assessed potential biomarkers for early HMOD in healthy persons and patients with hypertension. We hypothesised that plasma levels of biomarkers: (1) are different between healthy controls and patients with hypertension, (2): can classify patients with hypertension according to the degree of hypertension severity.
Design And Methods:
Patients with hypertension prescribed ≥2 antihypertensive agents were selected from a multicentre study. Healthy controls were selected from an ongoing study of living kidney donor candidates. Uncontrolled hypertension was defined as systolic daytime ambulatory blood pressure ≥135 mmHg. Kidney HMOD was defined by ACR > 3.0 mg/mmol or eGFR < 60 mL/min/1.73 m2. Patients with hypertension were categorised into three groups: (1) controlled hypertension; (2) uncontrolled hypertension without kidney HMOD; (3) uncontrolled hypertension with kidney HMOD. Fifteen biomarkers were analysed using a Luminex bead-based immunoassay, and nine fell within the specified analytical range.
Results:
Plasma levels of Interleukin 1 receptor antagonist (IL-1RA), neutrophil gelatinase-associated lipocalin (NGAL) and uromodulin were significantly different between healthy controls (n = 39) and patients with hypertension (n = 176). In regression models, with controlled hypertension (n = 55) as the reference category, none of the biomarkers were associated with uncontrolled hypertension without (n = 59) and with (n = 62) kidney HMOD. In models adjusted for cardiovascular risk factors and eGFR, osteopontin (OPN) was associated with uncontrolled hypertension without kidney HMOD (odds ratio (OR) 1.77 (1.05-2.98), p = 0.03), and regulated upon activation normal T-cell expressed and secreted (RANTES) with uncontrolled hypertension with kidney HMOD (OR 0.57 (0.34-0.95), p = 0.03).
Conclusions:
None of the biomarkers could differentiate our hypertension groups when established risk factors were considered. Plasma OPN may identify patients with uncontrolled hypertension at risk for kidney HMOD.
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