Abstract
THE AIM : to investigate the possibility of the use of urine biomarkers NGAL (neutrophil gelatinase-associated lipocalin) and KIM-1 (kidney injury molecule-1) for early detection of damage to proximal tubules (PT) and tubulointerstitium in nondiabetic hypertensive patients with CKD stage 2. PATIENTS AND METHODS . The research involved 60 patients (16 men and 44 women, mean age 60,4±8,37 years) with primary and nephrogenic hypertension, which were divided into 3 groups: 1 gr. with GFR>85 ml/min/1,73 m2 ), 2 gr. with GFR 60-74 ml/min/1,73 m2 ), and 3 gr. with GFR<60 ml/min/1,73 m2 ), The control group consisted 15 normotensive individuals (6 men and 9 women, mean age 49,8±9,68 years) without overt signs of kidney and cardiovascular diseases. All patients carried out a comprehensive survey with determination the content of urine NGAL («Human NGAL ELISA kit») and KIM-1 («Human KIM-1 Immunoassay ELISA»). RESULTS . Increased NGAL content In the urine of patients 2 and 3 gr. were identified respectively in 2,62 and 7,22 times compared with the control group. Augmentation the concentration of KIM-1 in the urine of the same patients groups was respectively 2,12 and 3,14 times. Similar results were obtained in a selected group (n = 30) of hypertensive patients with chronic heart failure with preserved ejection fraction. Urinary NGAL concentration in the group of patients with mild renal dysfunction (GFR 67,2±5,93 ml/min/1,73 m2 ) was higher than the comparison group data in 2,36 times, and in the patients with severe renal impairment (GFR 53,6±6,67 ml/min/1,73 m2 ) – to 9,09 times (p < 0,05). Similar data growth KIM-1 content in the urine of the patients with CHFpEF were respectively 1,84 and 6,87 times (p < 0,05). CONCLUSION . Urinary NGAL increase by more than 2,5 times and increase urinary KIM-1 more than 2 times compared with normal values can be diagnostic marker of early damage of PT and tubulointerstitium in nondiabetic hypertensive patients with stage 2 CKD.
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