PS-C33-11: FACTORS RELATED TO DETERIORATED KIDNEY FUNCTION IN RESISTANT HYPERTENSION PATIENTS

Abstract

Objectives: To determine the factors associated with renal function deterioration in resistant hypertension (RH) patients Methods: The study included 152 patients aged 28 to 79 years with RH. They underwent measurement of office and ambulatory blood pressure monitoring (ABPM). Blood level of potassium, sodium, glucose, creatinine, uric acid, citrulline, C-reactive protein (CRP), matrix metalloproteinase-12 (MMP-12), aldosterone-renin ratio and 24-h excretion of metanephrine and 24-h urinary albumin excretion rate (AER) were determined. Glomerular filtration rate (GFR) was estimated by the CKD-EPI formula. Results: Chronic kidney disease (CKD) was diagnosed in 32.3% of patients with RH (gr.1 pts), gr.2 pts - those without CKD. Spearman's correlation analysis showed a negative relationship between GFR and office diastolic BP (DBP) and 24 hours mean DBP (r = -0.233; r = -0.373; P < 0.01, respectively). Significant negative correlation was revealed between GFR and daytime systolic BP variability (r = -0.275; P < 0.01). GFR was inversely related to AER (r = -0.412; P < 0.01), uric acid (r = -0.311; P < 0.05), CRP (r = -0.314; P < 0.05), MMP-12 (r = -0.385; P < 0.01), citrulline (r = -0.375; P < 0.01), sodium (r = -0.284; P < 0.05), aldosterone and urinary metanephrine level (r = -0.225; P < 0.05 and r = - 0.210; P < 0.05). In gr.1pts. level of CRP, MM-12 and citrulline was significantly (P < 0.01) higher than in the gr.2 pts. Factors independently and most closely related to reduced GFR in RH patients are 24 hours mean DBP (β; = -0.449, P < 0.001), CRP (β; = -0.354, P < 0.01), MMP-12 (β; = -0.248; P < 0.01) and citrulline (β; = -0.232; P < 0.05). Conclusions: Revealed associations, in addition to elevated blood pressure, indicate the possible pathogenic role of low-grade systemic inflammation biomarkers in the renal function deterioration in RH patients. Targeting low-grade systemic inflammation may improve BP control in resistant hypertension patients with CKD.