Clinical significance of determination or urinary concentration of endothelial dysfunction and fibrogenesis markers in hypertensive nephropathy

M.L. Nanchikeeva, L.V. Kozlovskaya, V.V. Fomin, I.N. Bobkova, V.V. Rameev

Purpose. Determination of urinary excretion of molecular markers of endothelial dysfunction and fibrogenesis and evaluation of its relationship with clinical and laboratory signs of hypertensive nephropathy. Materials and methods. The study enrolled 71 patients with essential arterial hypertension (EAH) stages I-III, according to the classification of Russian Medical Society of Arterial Hypertension, aged 18 to 67 years (mean age, 40.9 ± 14.9 years). Along with physical examination, concentration of transforming growth factor-β1 (TGF-β1) in the urine, vascular endothelial growth factor (VEGF), plasminogen activator inhibitor type 1 (PAI-1) and collagen type IV were examined in all patients. Results. By comparison with normotensive controls, significant increase in urinary excretion of TGF-β1, VEGF and PAI-1 was observed in patients with EAH. The concentration of these neurotransmitters, as well as type IV collagen in urine was significantly higher in the presence of microalbuminuria. Conclusion. High concentration of TGF-β 1, VEGF and PAI-1 in the urine may be considered as an early sign of hypertensive nephropathy. Increased urinary excretion of type IV collagen is associated with microalbuminuria and gives evidence in favor of activation of renal fibrogenesis

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