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Monocyte to HDL ratio: a novel marker of resistant hypertension in CKD patients

  • Nephrology - Original Paper
  • Published:
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Abstract

Background

Inflammation, oxidative stress (OS), atherosclerosis and resistant hypertension (RH) are common features of chronic kidney disease (CKD) leading to a higher risk of death from cardiovascular disease. These effects seem to be modulated by impaired anti-oxidant, anti-inflammatory and reverse cholesterol transport actions of high-density lipoprotein cholesterol (HDL). HDL prevents and reverses monocyte recruitment and activation into the arterial wall and impairs endothelial adhesion molecule expression. Recently, monocyte count to HDL-cholesterol ratio (MHR) has emerged as a potential marker of inflammation and OS, demonstrating to be relevant in CKD. Our research was aimed to assess, for the first time, its reliability in RH.

Methods

We performed a retrospective study on 214 patients with CKD and arterial hypertension who were admitted between January and June 2019 to our Department, 72 of whom were diagnosed with RH.

Results

MHR appeared inversely related to eGFR (ρ = − 0.163; P = 0.0172). MHR was significantly higher among RH patients compared to non-RH ones (12.39 [IQR 10.67–16.05] versus 7.30 [5.49–9.06]; P < 0.0001). Moreover, MHR was significantly different according to the number of anti-hypertensive drugs per patient in the whole study cohort (F = 46.723; P < 0.001) as well as in the non-RH group (F = 14.191; P < 0.001). Moreover, MHR positively correlates with diabetes mellitus (ρ = 0.253; P = 0.0002), white blood cells (ρ = 0.664; P < 0.0001) and C-reactive protein (ρ = 0.563; P < 0.0001).

Conclusions

MHR may be a reliable biomarker due to the connection between HDL and monocytes. Our study suggests that MHR is linked with the use of multiple anti-hypertensive therapy and resistant hypertension in CKD patients, and can be a useful ratio to implement appropriate treatment strategies.

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Acknowledgements

We thank the nurse staff of the Unit of Nephrology and Dialysis for their help with the blood sampling and the blood pressure measurement of the patients.

Funding

This research received no external funding.

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Authors and Affiliations

  1. Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy

    Guido Gembillo, Rossella Siligato, Valeria Cernaro, Antonino Salvo, Adolfo Romeo, Vincenzo Calabrese & Domenico Santoro

  2. Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Messina, Italy

    Guido Gembillo & Ersilia Satta

  3. Nefrocenter Research Network, Naples, Italy

    Giovanni Conti

  4. Pediatric Nephrology Unit, AOU Policlinic “G Martino”, University of Messina, 98125, Messina, Italy

    Giovanna Sposito & Guido Ferlazzo

  5. Laboratory of Immunology and Biotherapy, Department of Human Pathology, University of Messina, Messina, Italy

    Giovanna Sposito & Guido Ferlazzo

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  1. Guido Gembillo
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  2. Rossella Siligato
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Contributions

Conceptualization, GG, DS, RS; data curation, RS, GG, AS, AR, GS; formal analysis, VC, VCA and GG; investigation, GG, DS; methodology, GG, GC and DS; supervision, GG, GC and DS; writing—original draft, GG, RS, DS and ES; writing—review & editing, GF, RS, GG and VC. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Guido Gembillo or Domenico Santoro.

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Gembillo, G., Siligato, R., Cernaro, V. et al. Monocyte to HDL ratio: a novel marker of resistant hypertension in CKD patients. Int Urol Nephrol 54, 395–403 (2022). https://doi.org/10.1007/s11255-021-02904-9

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