The Role of Two Heart Biomarkers in IgA Nephropathy.

Int J Mol Sci

2nd. Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary.

Published: June 2023

AI Article Synopsis

  • Cardiovascular mortality is a major concern in chronic kidney disease and IgA nephropathy, prompting this study to identify biomarkers that indicate disease outcomes based on vascular and heart changes.
  • The study involved 90 IgAN patients, measuring NT-proBNP for heart failure and CITP for fibrosis, revealing significantly higher levels of NT-proBNP, arterial stiffness (cfPWV), and central aortic systolic pressure in patients with more advanced kidney disease (CKD 3-5).
  • The findings suggest that NT-proBNP and CITP can help identify IgAN patients at risk for heart issues and related vascular diseases, with eGFR being the only independent predictor of NT-proBNP levels.

Article 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 ( = 0.035), cfPWV ( = 0.004), and central aortic systolic pressure ( = 0.037), but not CITP, in the CKD 3-5 group. Both biomarker positivities were significantly higher in the CKD 3-5 group ( = 0.035) compared to the CKD 1-2 group. The central aortic systolic pressure was significantly higher in the diastolic dysfunction group ( = 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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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299219PMC
http://dx.doi.org/10.3390/ijms241210336DOI Listing

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