Association between MR-proADM concentration and treatment intensity of antihypertensive agents in chronic kidney disease patients with insufficient blood pressure control.
Association between MR-proADM concentration and treatment intensity of antihypertensive agents in chronic kidney disease patients with insufficient blood pressure control.
复制标题
DOI：
10.1038/s41598-021-01403-2
复制
发表时间：
2021-11-09
影响因子：
4.6
通讯作者：
Itoh H
中科院分区：
文献类型：
--
作者：
Iwao M;Tanaka R;Suzuki Y;Nakata T;Aoki K;Fukuda A;Fukunaga N;Tatsuta R;Ohno K;Shibata H;Itoh H
慢性肾脏病（CKD）患者对降压药物的反应具有很大的个体差异性。肾上腺髓质素（ADM）在高血压中大量产生，但清除非常迅速。从ADM前体产生的中间区域proADM（MR-proADM）被认为是ADM定量的替代生物标志物。我们研究了血压（BP）控制不佳的CKD患者中MR-proADM与抗高血压抵抗的相关性。这项横断面研究分析了33例血压控制不佳的CKD患者，这些患者定义为尽管使用了至少两种降压药物但仍未能达到目标血压。计算治疗强度评分，以便于接受不同药物的受试者之间降压方案的可比性。使用超高效液相色谱-串联质谱法测量血浆MR-proADM浓度。血浆MR-proADM浓度与估计的肾小球滤过率（eGFR）相关（r =-0.777，p < 0.001）。治疗强度评分与血浆MR-proADM浓度呈正相关（r = 0.355，p = 0.043），经体重校正后，相关性进一步增强（r = 0.538，p = 0.001）。单因素和多因素回归分析确定MR-proADM浓度（p = 0.005）与体重校正治疗强度评分独立相关。MR-proADM可作为生物标志物，用于确定血压控制不良的CKD患者的降压药物治疗强度。
Response to antihypertensive drugs in patients with chronic kidney disease (CKD) has great interindividual variability. Adrenomedullin (ADM) is produced abundantly in hypertension, but clearance is very rapid. Mid-regional proADM (MR-proADM) produced from an ADM precursor is considered a surrogate biomarker for quantification of ADM. We investigated the association of MR-proADM with antihypertensive resistance in CKD patients with poor blood pressure (BP) control. This cross-sectional study analyzed 33 CKD patients with poor BP control defined as failure to achieve target BP despite at least two classes of antihypertensive drugs. Treatment intensity score was calculated to facilitate comparability of antihypertensive regimens across subjects taking different drugs. Plasma MR-proADM concentration was measured using ultra-performance liquid chromatography coupled with tandem mass spectrometry. Plasma MR-proADM concentration correlated with estimated glomerular filtration rate (eGFR) (r = − 0.777, p < 0.001). Treatment intensity score correlated positively with plasma MR-proADM concentration (r = 0.355, p = 0.043), and the correlation was further enhanced after correction by weight (r = 0.538, p = 0.001). Single and multiple regression analysis identified MR-proADM concentration (p = 0.005) as independently associated with weight-corrected treatment intensity score. MR-proADM may be useful as a biomarker to determine the therapeutic intensity of antihypertensive drugs in CKD patients with poor BP control.
登录
查看更多内容
影响因子：
3.7
作者：
Gouya, Ghazaleh;Sturm, Gisela;Kronenberg, Florian
通讯作者：
Kronenberg, Florian
影响因子：
3
作者：
Suzuki, Yosuke;Itoh, Hiroki;Takeyama, Masaharu
通讯作者：
Takeyama, Masaharu
影响因子：
2.3
作者：
Konta, Tsuneo;Kudo, Kosuke;Kubota, Isao
通讯作者：
Kubota, Isao
影响因子：
13.2
作者：
Matsuo, Seiichi;Imai, Enyu;Hishida, Akira
通讯作者：
Hishida, Akira
影响因子：
2.7
作者：
López, J;Cuesta, N;Cuttitta, F
通讯作者：
Cuttitta, F