BACKGROUND:Catheter-based renal denervation (RDN) reduces blood pressure in hypertension. Urinary peptides are associated with cardiovascular and renal disease and provide prognostic information. We aimed to investigate the effect of RDN on urinary peptide-based biomarker panels associated with chronic kidney and heart disease and to identify urinary peptides affected by RDN.METHODS:This single-arm, single-center study included patients undergoing catheter-based RDN. Urine samples were collected before and 24 months after RDN and were analyzed using capillary electrophoresis coupled with mass spectrometry. Predefined urinary peptide-based biomarker panels for chronic kidney disease (CKD273), coronary artery disease (CAD238), and heart failure (HF1) were calculated.RESULTS:This study included 48 patients (33% female) with uncontrolled hypertension. At 24 months after RDN, systolic blood pressure (165±17 versus 148±20 mm Hg; P<0.0001), diastolic blood pressure (90±17 versus 81±13 mm Hg; P<0.0001), and mean arterial pressure (115±15 versus 103±13 mm Hg; P<0.0001) decreased significantly. A total of 103 urinary peptides from 37 different proteins, mostly collagens, altered following RDN. CAD238, a 238 coronary artery-specific polypeptide pattern, significantly improved following RDN (Cohen’s d, −0.632; P=0.0001). The classification scores of HF1 (P=0.8295) and CKD273 (P=0.6293) did not change significantly.CONCLUSIONS:RDN beneficially affected urinary peptides associated with coronary artery disease.REGISTRATION:URL: https://www.clinicaltrials.gov; Unique identifier: NCT01888315.

中文翻译：

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肾去神经支配对高血压尿肽生物标志物的影响

背景：基于导管的肾去神经术（RDN）可降低高血压患者的血压。尿肽与心血管和肾脏疾病相关，并提供预后信息。我们的目的是研究 RDN 对与慢性肾病和心脏病相关的基于尿肽的生物标志物组的影响，并确定受 RDN 影响的尿肽。方法：这项单臂、单中心研究包括接受基于导管的 RDN 的患者。在 RDN 之前和之后 24 个月收集尿液样本，并使用毛细管电泳结合质谱法进行分析。计算了针对慢性肾病 (CKD273)、冠状动脉疾病 (CAD238) 和心力衰竭 (HF1) 的预定义尿肽生物标志物组。 结果：本研究包括 48 名未受控制的高血压患者（33% 为女性）。 RDN 后 24 个月时，收缩压（165±17 对比 148±20 mm Hg；P <0.0001）、舒张压（90±17 对比 81±13 mm Hg；P <0.0001）和平均动脉压（115 ±15 与 103±13 mm Hg；P <0.0001）显着下降。来自 37 种不同蛋白质（主要是胶原蛋白）的总共 103 种尿肽在 RDN 后发生了变化。 CAD238（一种 238 冠状动脉特异性多肽模式）在 RDN 后显着改善（Cohen's d，-0.632；P = 0.0001）。 HF1 ( P = 0.8295) 和 CKD273 ( P = 0.6293)的分类评分没有显着变化。 结论：RDN 对与冠状动脉疾病相关的尿肽有有益影响。唯一标识符：NCT01888315。