#606 Relationship between vascular biomarkers, NT-proBNP and renal function in chronic kidney disease, IgA nephropathy

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Abstract Background and Aims IgA nephropathy (IgAN) is the most common primary glomerular disease. Endothelin-1 (ET-1) is one of the strongest vasoconstrictor material in the blood. N-terminal prohormone of brain natriuretic peptide (NT-proBNP) is associated with renal function and poor outcomes in chronic kidney disease (CKD). Serum endocan is a biomarker associated with proinflammatory cytokines and the increase of serum level plays a critical role in inflammatory, proliferative, and neovascularisation processes associated with poor cardiovascular outcomes in patients with CKD too. Identifying high-risk patients using biomarkers could help to optimise their treatment. Method Ninety patients with biopsy-confirmed IgAN were included in the study (50 males/40 females, mean age: 54.9 ± 14.4 years). Serum endocan, ET-1 and NT-proBNP were measured by enzyme-linked immunosorbent assay kits. Echocardiography was performed and carotid-femoral pulse wave velocity (cfPWV) was measured by SphygmoCor in this cross-sectional study. Results Patients were divided into two groups based on serum endocan median level (cut-off: 44 µg/l). There was significantly higher aorta systolic blood pressure (SBPao) (P = 0.013), NT-proBNP (P = 0.028), albumin/creatinine ratio (P = 0.036) and uric acid (P = 0.045) in case of the higher endocan group compared to the lower. There was also significantly higher SBPao (P = 0.037) and NT-proBNP (P = 0.038) in the case of higher endothelin-1 (ET-1) levels compared to the lower (cut-off: 231 pg/ml) group by two-sample t-test. Then we divided the patients into two groups based on the eGFR (CKD 1–2 vs. CKD 3–5). The serum endocan, NT-proBNP, cfPWV, SBPao, left ventricular mass index (LVMI), uric acid and albuminuria were significantly higher in the CKD 3–5 group compared to the CKD 1–2 group. The serum endocan and NT-proBNP levels were significantly higher in the diastolic dysfunction group (P = 0.047, P = 0.015). There was a significant increase in serum endocan levels (CKD 1 vs. CKD 5; P = 0.008) with decreasing renal function. Conclusion In IgAN, vascular biomarkers (endocan, ET-1) may play a role in endothelial dysfunction through vascular damage and elevation of SBPao. Serum endocan, ET-1 and NT-proBNP biomarkers may help to identify IgAN patients at high risk.

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