Relationship between lactate dehydrogenase and albuminuria in Chinese hypertensive patients

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Vol. 23; no. 1; pp. 128 - 136
• Main Authors: Cai, Xiaoqi, Wang, Tingjun, Ye, Chaoyi, Xu, Guoyan, Xie, Liangdi
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.01.2021; John Wiley and Sons Inc; Wiley
• Subjects: Aged; Albuminuria; Albuminuria - diagnosis; Albuminuria - epidemiology; China - epidemiology; Creatinine; Cross-Sectional Studies; Dehydrogenases; Female; Humans; Hypertension; L-Lactate Dehydrogenase; lactate dehydrogenase; Male; Original Paper; China; lactate dehydrogenase; albuminuria; hypertension
• ISSN: 1524-6175; 1751-7176
• DOI: 10.1111/jch.14118

Lactate dehydrogenase (LDH) has been reported to be positively correlated with albuminuria assessed by urinary albumin‐to‐creatinine ratio (UACR) in patients with sickle cell disease; both LDH and albuminuria are positively associated with the severity of hypertension (HTN). Here, a cross‐sectional study was performed to investigate the association between LDH and albuminuria in Chinese hypertensives. A total of 1169 Chinese individuals (aged 58.0 ± 11.5 years, 60.4% male), who were admitted to our hospital, were included in this study. Based on the level of LDH, all hypertensives (n = 802) were divided into three groups: HTN1 (lowest tertile of LDH, n = 264), HTN2 (mediate tertile of LDH, n = 268), and HTN3 (highest tertile of LDH, n = 270). Hypertensives with hyperhomocysteinemia were defined as hypertensives with homocysteine ≥15μmol/L. Meanwhile, 367 normotensives served as controls. Compared with normotensives, the levels of LDH and UACR were significantly higher in hypertensives (p < .05). There was an increasing trend of albuminuria (UACR ≥30 mg/g) from control, HTN1, HTN2 to HTN3 group (4% vs. 12.1% vs. 14.9% vs. 19.6%, χ2 = 38.886, p < .001). Stepwise multiple regression analysis showed an independent association between LDH and UACR in patients with HTN (β = 0.085, p < .05), but not in normotensives. After further stratification in hypertensive patients, this correlation remained in the male (β = 0.161, p < .001), elderly (age ≥65 years, β = 0.174, p < .001) and especially hypertensives with hyperhomocysteinemia (β = 0.402, p < .001). LDH combined with white blood cell (WBC) counts was observed to have better discrimination for albuminuria than creatinine united with cystatin C in hypertensives according to receiver operation characteristic curves (area under curve: 0.637 vs. 0.535, z = 2.563, p = .0104). In conclusion, the level of LDH was associated with albuminuria in Chinese patients with HTN, particularly in hypertensives with hyperhomocysteinemia. LDH combined with WBC provided better prediction of albuminuria than routine renal function assessment in hypertensives. Further studies are needed to confirm LDH as an early marker for the risk of kidney involvement among hypertensives. The incidence of albuminuria was increased along with the increment of LDH level in patients with HTN. LDH correlated independently with UACR in the elderly, male and especially hypertensives with hyperhomocysteinemia. Moreover, LDH combined with WBC provides better prediction of albuminuria than creatinine united with cystatin C in hypertensives.