International Journal of Medical Laboratory Research (IJMLR)

EVALUATION OF SELECTED RENAL MARKERS IN HYPERTENSIVE SUBJECTS IN EKITI STATE, NIGERIA

​

Adeola O. Oluboyo

 

ABSTRACT: Hypertension has become a serious health challenge in the 21st century because it may cause organ damage as it progresses and could result in increased morbidity and mortality. The study evaluated selected renal markers (urea, creatinine, uric acid and cystatin C) in hypertensive subjects relative to control. A total of 92 subjects were investigated consisting of 31 hypertensive subjects on treatment, 31 hypertensives not on treatment and 30 apparently healthy subjects who served as control subjects. The levels of urea, creatinine and uric acid were determined using spectrophotometric methods while cystatin C was analyzed using enzyme linked immunoassay (ELISA) technique. Blood pressure and body mass index (BMI) were also measured in addition to the selected markers. The results showed that urea, uric acid, blood pressure and BMI were significantly higher at p<0.05 while creatinine and cystatin C did not show significant difference (p>0.05) in hypertensive subjects compared with control. It was concluded that urea, uric acid, blood pressure and BMI were significantly high in hypertension. Measurement of these markers could be helpful in identification of patients at high risk of developing renal complications associated with hypertension.

​

KEY WORDS: hypertension, urea, creatinine, uric acid,  cystatin C

​

REFERENCES:

1. Macgill M, Markus L. Hypertension: causes, symptoms and treatment. Medical news today. Medilexicon. The American Journal of Medicine. 2017; 34,16:24-30.

2. Ogunlesi A, Osotimehin B, Abbiyessuku F, et al. Blood pressure and educational level among factory workers in Ibadan, Nigeria. J Hum Hypertens 1991;5,5:375-380.

3. Rodriguez MA, Kumar SK, De Caro M. Hypertensive crisis. Cardiology Review. 2010;  18,2: 102-107.

4. White WB. Defining the problem of treating the patient with hypertension and arthritis pain. Am. J. Med. 2009; 122, 5: S3–9.

5. Escobales N, Maria J. Oxidative-Nitrosative Stress in Hypertension. Curr. Vasc. Pharmacol. 2005; 3,3:231-246.

6. Wu CL, Tsai CC, Kor CT, Tarng DC, Lian IB, Yang TH, et al. Stroke and Risks of Development and Progression of Kidney Diseases and End-Stage Renal Disease: A Nationwide Population-Based Cohort Study. PLoS ONE. 2016; 11,6: e0158533.

7. Merai R, Siegel C, Rakotz M, Basch P, Wright J, Wong B. CDC Grand Rounds: A Public Health Approach to Detect and Control Hypertension. Morbidity Mortality Weekly Report. 2016; 65,45:1261-1264.

8. Traynor J, Mactier R, Geddes CC,  Fox JG. How to measure renal function in clinical practice. Br. Med. J. 2006; 333,7571:733-737.

9. Gowda S, Desai PB, Kulkarni ss Hull VV,  Math A, Vernekar SN. Markers of renal function tests. N Am J Med Sci. 2010; 2,4:170-173.

10. Doyle JF, Forni LG. Acute kidney injury: short-term and long-term effects. Crit Care. 2016; 20, 188.

11. Wiles K, Bramham K, Seed PT, Nelson-Piercy C, Lightstone L, Chappell LC. Serum Creatinine in Pregnancy: A Systematic Review. Kidney Int Rep. 2019; 4,3:408-419.

12. Taal MW. Chronic kidney disease: towards a risk-based approach. Clin Med (Lond). 2016; 16,6: s117–s120.

13. Madero M, Sarnak MJ, Wang X. Uric acid and long-term outcomes in CKD. American Journal of Kidney Disease. 2009; 53:796–803.

14. Cicero AF, Salvi P, D’Addato S. Association between serum uric acid, hypertension, vascular stiffness and subclinical atherosclerosis: data from the Brisighella Heart Study. Journal of Hypertension. 2014; 32:57–64.

15. Kuwabara M, Hisatome I, Niwa K, Hara S, Roncal-Jimenez CA, Bjornstad P, et al. Uric acid is a strong risk marker for developing hypertension from prehypertension: a 5-year Japanese cohort study. Hypertension. 2018; 71:78–86.

16. Feig DI, Madero M, Jalal DI, Sanchez-Lozada LG, Johnson RJ. Uric acid and the origins of hypertension. Journal of Pediatrics. 2013; 162:896–902.

17. Borghi C, Tubach F, De Backer G, Dallongeville J, Guallar E, Medina J. et al. Lack of control of hypertension in primary cardiovascular disease prevention in Europe: results from the EURIKA study. International Journal of Cardiology. 2016; 218:83–88.

18. Shlipak MG, Matsushita K, Arnlov J, Inker LA, Katz R, Polkinghorne KR, et al. Cystatin C versus creatinine in determining risk based on kidney function. N Engl J Med. 2013;369:932–943.

19. Grubb A. 2017. Cystatin C is Indispensable for Evaluation of Kidney Disease. EJIFCC. 2017; 28,4: 268–276.

20. Rebollo N. Cepeda-Piorno FJ. Cystatin C for Therapeutic Drug Monitoring. Clinical Chemistry; 2015; 61:6804–6808

21. AJ Taylor and P Vadgama Analytical reviews in clinical biochemistry: the estimation of urea Ann Clin Biochem 1992; 19: 245-264

22. Larsen K. Creatinine assay by a reaction-kinetic principle. Clin Chim Acta. 1972;41:209-217.  

23. Fossati P, Prencipe L, Berti G. Use of 3,5-dichloro-2-hydroxybenzene sulphonic acid / 4 aminophenazone chromogenic system in direct enzymatic assays of uric acid in serum and urine. Clin. Chem. 1980; 26:227-231

24. Xia LH, Bing XG, An XT. Grubb A: serum cystatin C assay for the detection of early renal impairment in diabetic patients. J Clin Lab Anal. 2004;18,1:31–35.

25. Flack JM, Siva DA, Barkis G. Management of high blood pressure in Blacks: an update of the International Society on hypertension in Blacks consensus statement. Hypertension. 2010; 56:780-800.

26. Oluboyo AO, Zaruq AO, Oluboyo BO, Onyeaghala AA, Olayanju AJ. Assessment Of Serum Interleukin-18 And Some Markers Of Hypertension. British Journal of bio-medical research.2018; 2,4:420-425

27.  Mungreiphy NK, Kapoor S, Sinha R. Association between BMI, Blood Pressure, and Age: Study among Tangkhul Naga Tribal Males of Northeast India. Journal of Anthropology. 2011; 2011; 748147

28. Srikanth J, Jayant Kumar K, Narasimha NS. Factors influencing obesity among urban high school children Bangalore City. Indian J Nutr Dietet. 2011;48:8–17.

29. Dua S, Bhuker M, Sharma P, Dhall M, Kapoor S. Body Mass Index Relates to Blood Pressure Among Adults. N Am J Med Sci. 2014; 6,2: 89–95.

30.  Marra MV, Simmons SF, Shotwell MS, Hudson A, Hollingsworth EK,  Kuertz ELB et al. Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index. Journal of the Academy of Nutrition and Dietetics. 2016; 116 ,5:828-836.

31. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. American Heart Association. 2006; 47,2:296-308.

32. Padma Y,  Aparna VB, Kalpana B, Ritika V, Sudhakar PR. Renal markers in normal and hypertensive disorders of pregnancy in Indian women: a pilot study. Int J Reprod Contracept Obstet Gynecol. 2013; 2,4: 514–520.

33. Feig DI, Kang DH, Johnson RJ. Uric acid and cardiovascular risk. New England Journal of Medicine. 2008;359:1811–1821.

34. Zhang J, Rudemiller NP, Wu M, McDonough AA, Crowley SD. Interleukin-1 Receptor Activation Potentiates Salt Reabsorption in Angiotensin II induced Hypertension via NHCC2 Co-transporter in the nephron. Cell metabolism. 2016; 23,2: 360-368.

35. Sedaghat S, Hoorn EJ, van Rooij FJA, Hofman A, Franco OH, Witteman JCM, et al. Serum Uric Acid and Chronic Kidney Disease: The Role of Hypertension. PLoS ONE. 2013; 8,11: e76827.

36. Grossman E, Verdecchia P, Shamiss A, Angeli F, Reboldi  G. Diuretic Treatment of Hypertension. Diabetes Care. 2011; 34,2: S313–S319.

37. Tamanji MT, Ngwakum DA,  Mbouemboue OP. A Profile of Renal Function in Northern Cameroonians with Essential Hypertension. Cardiorenal Med. 2017;7:324-333