Kidney Week

Abstract: FR-PO755

Kidney Tubule Injury and Dysfunction Biomarkers and Risk of Incident Hypertension in Community-Living Individuals: Results From the Multi-Ethnic Study of Atherosclerosis

Session Information

• Hypertension and CVD: Clinical, Outcomes, Trials
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1502 Hypertension and CVD: Clinical‚ Outcomes‚ and Trials

Authors

• Malhotra, Rakesh, University of California San Diego, La Jolla, California, United States

Rakesh Malhotra,

• Katz, Ronit, University of Washington, Seattle, Washington, United States

Ronit Katz,

• Kimmel, Paul L., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Paul L. Kimmel,

• Ramachandran, Vasan S., Boston University School of Medicine, Boston, Massachusetts, United States

Vasan S. Ramachandran,

• Al-Rousan, Tala, University of California San Diego, La Jolla, California, United States

Tala Al-Rousan,

• Greenberg, Jason Henry, Yale University, New Haven, Connecticut, United States

Jason Henry Greenberg,

• Parikh, Chirag R., Johns Hopkins University, Baltimore, Maryland, United States

Chirag R. Parikh,

• Bonventre, Joseph V., Brigham and Women's Hospital, Boston, Massachusetts, United States

Joseph V. Bonventre,

• Schelling, Jeffrey R., University Hospitals, Cleveland, Ohio, United States

Jeffrey R. Schelling,

• Sarnak, Mark J., Tufts Medical Center, Boston, Massachusetts, United States

Mark J. Sarnak,

• Gutierrez, Orlando M., UAB Health System, Birmingham, Alabama, United States

Orlando M. Gutierrez,

• Shlipak, Michael, UCSF Medical Center, San Francisco, California, United States

Michael Shlipak,

• Ix, Joachim H., University of California San Diego, La Jolla, California, United States

Joachim H. Ix,

Background

Hypertension (HTN) is a major risk factor for the onset and progression of chronic kidney disease (CKD) and cardiovascular disease (CVD). However, the mechanisms leading to essential HTN remain elusive. Here, we evaluated the association between tubule biomarkers and risk of developing HTN.

Methods

We randomly sampled 463 MESA participants who did not have prevalent CKD or diabetes, but excluded 166 participants who had prevalent HTN. We measured six plasma tubule biomarkers (KIM-1, MCP-1, suPAR, TNFR1, TNFR2 and YKL-40) and five urinary tubule biomarkers (EGF, KIM-1, MCP-1, YKL-40 and urine albumin) at baseline. The primary outcome was the development of incident HTN, defined as either a systolic BP≥ 140 mmHg, a diastolic BP ≥ 90 mmHg, or the use of any antihypertensive medication during a follow-up period. Multivariable Poisson regression was used to examine associations between baseline kidney tubule markers and urine albumin with incident HTN.

Results

Among the 297 participants, the mean age was 58±10 years, 53% were women, 47% were White, and 20% were Black. The median number of BP measurements per participant was 6 (IQR 2 to 10). Nearly half (N=142) developed incident HTN event over 15 years of follow-up. In unadjusted models, higher urinary KIM-1, MCP-1 and urine albumin, as well as higher plasma MCP-1 and YKL-40 were individually associated with risk of incident HTN (Figure 1). However, in the fully adjusted model, only urine albumin remained associated with incident HTN (IRR 1.25 (1.1 to 1.5); P < .005).

Conclusion

In this study of community-living individuals without CKD, diabetes, or CVD, in an adjusted model there was no association of selected kidney tubule injury or dysfunction biomarkers with incident HTN. In comparison, urine albumin was independently associated with incident HTN.

Funding

• NIDDK Support