Tanqi Lou

Patients with both hypertension and hyperhomocysteinemia, termed H‐type hypertension, have a high risk for cardiocerebrovascular diseases. However, little is known about the prevalence of H‐type hypertension or its role in target organ damage in patients with chronic kidney disease (CKD). The authors recruited 1042 patients with CKD who were admitted to their hospital division. Multiple linear regression analyses were used to evaluate the association between H‐type hypertension and renal/cardiovascular parameters. A total of 460 (44.14%) CKD patients had H‐type hypertension. Multivariate logistic regression analysis showed that H‐type hypertension is associated with serum albumin, uric acid, estimated glomerular filtration rate (eGFR), and 24‐hour systolic blood pressure. Patients with H‐type hypertension had the worst renal function and left ventricular hypertrophy among all patients, while the levels of carotid intima‐media thickness (cIMT) in patients with H‐type hypertension were only slightly higher than in patients with normotension and normohomocysteinemia (P<.05). H‐type hypertension was associated with eGFR, left ventricular mass index, and cIMT according to multiple linear regression analyses. The prevalence of H‐type hypertension was high and H‐type hypertension was associated with target organ damage in patients with CKD.

Diabetic kidney disease is the leading cause of end-stage renal disease in developed and developing countries. Microalbuminuria is the gold standard for detection and prediction of diabetic kidney disease and cardiovascular risk disease in clinical practice. However, microalbuminuria has several limitations, such as lower sensitive, larger variability. It is urgent to explore higher sensitivity and specificity for earlier detection of diabetic kidney disease and more accurate prediction of the progression to end stage renal disease. We reviewed some new and important urinary biomarkers, such as: transferrin, immunoglobulin G, immunoglobulin M, Cystanic C, podocytes, type IV collagen, 8-oxo-7, 8-dihydro-2'-deoxyguanosine, ceruloplasmin, monocyte chemoattractant protein-1 and so on. We need good quality, long-term, large longitudinal trials to validate published biomarkers and find new biomarkers, considering biomarkers reviewed here are from small cross-sectional studies.