Abstract 15713: Increased Plasma Soluble (Pro)renin Receptor Levels are Correlated With Renal Dysfunction in Patients With Heart Failure
Background: Renal dysfunction is commonly associated with with heart failure (HF), and one of the independent predictors for its poor outcomes, including all-cause death and worsening HF. The renin-angiotensin system (RAS) has been shown to be involved in the development and progression of chronic kidney disease as well as HF. The (pro)renin receptor ((P)RR), a receptor for renin and prorenin, regulates the tissue RAS and is reported to contribute to cardiovascular and renal damages in hypertensive and diabetic animal models. These findings suggest that (P)RR is also involved in HF especially complicated with renal dysfunction. We thus determined whether plasma soluble (P)RR was associated with renal dysfunction in patients with HF.
Methods and Results: Forty four consecutive patients with HF (57.9±14.1 years old, New York Heart Association class I-III, left ventricular ejection fraction 33.5±11.6%) and 28 age-matched healthy subjects as controls (52.3±8.7 years old) were studied. Causes of HF were ischemic in 30% and non-ischemic in 70%. HF patients had significantly higher plasma soluble (P)RR levels (14.09±4.63 vs. 9.13±2.25 ng/mL, P<0.001). Estimated glomerular filtration rate (eGFR) were significantly decreased in patients with HF compared to controls (60.8±23.9 vs. 75.2±13.4, P<0.001). By univariate analysis, plasma brain natriuretic peptide (r=0.489, P<0.001), serum blood urea nitrogen (r=0.559, P<0.001), and eGFR (r=-0.619, P<0.001) were significantly correlated with plasma soluble (P)RR levels among HF patients. In contrast, circulating levels of RAS components were not correlated with plasma soluble (P)RR levels and eGFR. By multivariate analysis, only eGFR was identified as an independent determinant of soluble (P)RR levels (β-coefficient=-5.58, 95%CI [-10.2, -0.95], P=0.019).
Conclusion: Plasma soluble (P)RR levels were significantly elevated in HF and significantly associated with impaired renal function in these patients. (P)RR can be a useful marker and a potential therapeutic target of renal dysfunction associated with HF.
- © 2013 by American Heart Association, Inc.