Value of the NOS3 gene Т786С polymorphism for early diagnosis of kidney damage in patients with essential arterial hypertension

Abstract

Background . Essential arterial hypertension (AH) is a global problem of the healthcare system. Kidney damage could aggravate the course of the disease, and genetic factors play an important role in the development of hypertensive nephropathy: approximately 50% of patients are carriers of genetic polymorphisms that predispose to the occurrence of hypertensive nephropathy. Objective . Studying the relationship between genetical disorders and features of intrarenal blood flow among patients with AH. Design and methods . 114 patients (49 men and 65 women) aged 35 to 58 years with stage I–II hypertension and 1–3 degrees of arterial hypertension were examined. Duplex scanning of renal arteries was performed using a Vivid-7 Dimension ultrasound scanner, genotyping of the Т786С polymorphism of the NOS3 gene using a real-time polymerase chain reaction; the calculated glomerular filtration rate (using the CKD-EPI formula) was analyzed. The examined patients were divided into 2 groups: the 1st group included individuals with glomerular filtration rate (GFR) greater than or equal to 60 ml/min/1,73 m 2 (32 men and 40 women), the 2nd group — with GFR 45–59 ml/min/1,73 m 2 (17 men and 25 women). Results . In patients with hypertension with GFR 45–59 ml/min/1,73 m2 , the predominance of the CC genotype and allele- C was found, and among patients with GFR greater than or equal to 60 ml/min/1,73 m 2 , the TC genotype and allele- Т prevailed. In the second group, higher values of peripheral resistance indices were observed in comparison with the first group. It was also found that individuals with TC and CC genotypes had higher indices of peripheral resistance of intrarenal blood flow compared to patients with TT genotype. Conclusion . The presence in the genotype of patients with arterial hypertension of the 786C allele and the CC genotype of the NOS3 gene can predispose to early kidney damage, and an increase in the indices of peripheral resistance of blood flow in the interlobar renal arteries can serve as a criterion for the development of hypertensive nephropathy in patients with arterial hypertension.