Abstract
The potential association between altered levels of plasma free amino acids (PFAAs) and uric acid (UA) with estimated glomerular filtration rate (eGFR) remains unknown among patients with hypertension. A total of 2804 healthy controls and 2455 hypertensive patients were included in the current analysis. eGFR was defined as reduced when it was <60 ml/min/1.73 m2. The associations between reduced eGFR and individual PFAAs and UA in the healthy control and hypertension groups were explored by logistic regression analyses adjusted for potential confounding variables. Results show that UA had a significant positive association with reduced eGFR in both healthy control and hypertension groups (P < 0.001). Among the PFAAs, citrulline, glycine and phenylalanine showed significant positive associations with reduced eGFR in both healthy control (P < 0.01 to 0.001) and hypertension (P < 0.001) groups. Moreover, alanine, asparagine and methionine achieved significant positive associations with reduced eGFR only in the hypertension group (P < 0.01 to 0.001). Conversely, serine showed significant inverse associations with reduced eGFR in the hypertension group only (P < 0.001). Our findings provide first evidence for a strong relationship between distinct patterns of PFAAs and elevated UA with reduced eGFR in hypertension. The findings may appear useful in developing effective strategies for the prevention or early detection and treatment of declined kidney function in hypertension.
Highlights
Kidney function decline has consistently been found to be a strong independent risk factor for adverse clinical outcomes in a broad spectrum of patients[1]
We investigated the association between plasma free amino acids (PFAAs) and uric acid (UA) with reduced estimated glomerular filtration rate (eGFR) in both groups of subjects in an attempt to explore the existence of any relationships between alterations in PFAA and UA levels with reduced eGFR in hypertension
Compared to the subjects in the healthy control group, the patients with hypertension exhibited significantly higher values for all the demographic and clinical variables (Mann-Whitney U-test, P < 0.001) except for high-density lipoprotein cholesterol (HDLC) and eGFR, which were significantly lower in the hypertension group (Mann-Whitney U-test, P < 0.001)
Summary
Kidney function decline has consistently been found to be a strong independent risk factor for adverse clinical outcomes in a broad spectrum of patients[1]. Published data suggest that in chronic kidney diseases, alterations in the levels of plasma free amino acids (PFAAs) appear early and are more pronounced in advanced stages of it[6]. From the findings of various clinical, epidemiological and experimental studies, both altered levels of PFAAs and UA appear to be independently and significantly associated with impaired kidney function which may be of particular importance among patients with hypertension. Any such potential relationship remains unknown as no study have hitherto investigated it in the general population. A better understanding of reduced eGFR in hypertension and its association with PFAAs and UA might contribute to better apprehension of the disease pathophysiology, and help in the prevention or early detection and treatment of acute and chronic kidney diseases with declined kidney function in hypertension
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