Prognosis of Chronic Kidney Disease Development in Hypertensive Patients Depending on the CYP11B2 Gene (rs1799998) Allelic State of

Abstract

The assessment of the hypertensive-mediated organ damage (HMOD) state is important for the hypertensive patients’ risk stratification. The objective: to assess the risks of chronic kidney disease (CKD) in patients with essential arterial hypertension (EAH) depending on the Cytochrome 11b2 Aldosterone Synthase Gene (CYP11B2, rs1799998) allelic state. Materials and methods. 100 hypertensive patients with hypertensive-mediated target-organ damaging (2nd stage), moderate, high or very high cardiovascular risk were enrolled in the case-control study and underwent complex of clinical-laboratory investigation with following epidemiological analysis. Mean age 59.87±8.02 y.o. CKD was diagnosed according to the National Kidney Foundation recommendations (2012) after glomerular filtration rate (GFR) decline measured by CKD-EPI equations after Creatinine, or Cystatin-C blood level. Control group included 48 practically healthy persons of relevant age. Gene’s nucleotide polymorphism CYP11B2 (–344C/T) was examined by polymerase chain reaction in 72 EAH patients and in control group. Results. The probability of CKD in the T-allele carriers of the CYP11B2 gene (rs1799998) increases after GFR decrease (cystatin-C) almost 1.5 times [OR=1.86; 95 % OR:1.01–3.58; p=0.049], especially in women [OR=2.23; 95 % OR:0.99–5.90; p=0.052]. The presence of type 2 diabetes mellitus in EAG patient increases the CKD risk 2.4 times [OR=3.29; 95 % OR:1.06–10.19; p=0.034], the obesity onset increases risk 2.08 and 2.32 times [OR=3.30; 95 % OR:1.33–8.16; p=0.009 and OR=3.58; 95 % OR:1.02–9.34; p=0.048, respectively], 3rd degree blood pressure elevation increases the probability of CKD almost three times [OR=5.06; 95 % OR:1.942–13.23; pConclusion. The CKD risk (after creatinine) in the mutation T-allele carriers’ women increases 6.5 times (p=0.007) with the lowest probability of such changes in T-allele carriers’ men [OR = 0.15; p=0.009].