Abstract
The (pro)renin receptor ((P)RR) is cleaved to generate soluble (P)RR (s(P)RR), which reflects the status of the tissue renin-angiotensin system. Hemodialysis (HD) patients have a poor prognosis due to the increased prevalence of cardiovascular diseases. The present study aimed to investigate whether serum s(P)RR level is associated with the worsening of cardiac function in HD patients. A total of 258 maintenance HD patients were recruited and serum s(P)RR concentration was measured. Background factors in patients who survived (S group) and patients who died (D group) during the 12-month follow-up period and relationships between serum s(P)RR level and changes in cardiac function during the follow-up period in the S group were investigated. The median serum s(P)RR value at baseline was 29.8 ng/ml. Twenty-four patients died during the follow-up period. Cardiothoracic ratio, human atrial natriuretic peptide (hANP), brain natriuretic peptide (BNP), and E over e-prime were significantly higher in the D group. In the S group, changes in hANP or BNP were significantly greater in the higher serum s(P)RR group than in the lower serum s(P)RR group. High serum s(P)RR level was significantly correlated with changes in BNP, independent of other factors. High serum s(P)RR level was associated with increases in BNP, independent of other risk factors, suggesting that an increased expression of (P)RR may be associated with a progression of heart failure in HD patients and that serum s(P)RR concentration could be used as a biomarker for selecting patients requiring intensive care.
Highlights
Therenin receptor ((P)RR) consists of 350 amino acids with a single transmembrane domain and binds preferentially to renin and prorenin [1]
Heart failure was a strong, independent, adverse prognostic indicator in these patients [27]. In accordance with these findings, our study showed that cardiothoracic ratio (CTR), human atrial natriuretic peptide (hANP) and brain natriuretic peptide (BNP) levels, and E/e’ were significantly higher and LVEF was significantly lower in the death group than in the survival group (Table 2), suggesting that the status of systolic and diastolic dysfunction and heart failure are related to increased risk of death in HD patients
In patients who survived, ΔhANP and ΔBNP levels and ΔIVST were significantly higher in patients with serum s(P)RR 29.8 ng/ml than in those with s(P)RR
Summary
The (pro)renin receptor ((P)RR) consists of 350 amino acids with a single transmembrane domain and binds preferentially to renin and prorenin [1]. Age (y.o.) Gender (male/female) Body mass index (kg/m2) Primary disease (DM/non DM) Duration of hemodialysis therapy (months) Smoking history (yes/no) Medications (yes/no) RAS-I β-blocker CCB CTR (%) Kt/V. Blood tests s(P)RR (ng/ml) Hemoglobin (g/dl) HDL cholesterol (mg/dl) LDL cholesterol (mg/dl) Triglyceride (mg/dl) Calcium (mg/dl) Inorganic phosphorus (mg/dl) Intact-Parathyroid hormone (pg/ml) Creatinine (mg/dl) Uric acid (mg/dl) CRP (mg/dl) Albumin (g/dl) hANP (pg/ml) BNP (pg/ml) survival.
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