Phenotyping of patients with arterial hypertension based on the renal filtration function and arterial stiffness using cluster analysis

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Abstract

Arterial hypertension (AH) and chronic kidney disease (CKD) mutually aggravate each other, forming a cardiorenal continuum with a high risk of complications. Study of their correlation through the prism of arterial stiffness is relevant for stratifying such kind of patients and optimizing their therapy.

The aim of the research is phenotyping patients with AH basing on the condition of renal filtration function and elastic properties of arterial wall using cluster analysis (CA) and determination of the clinical features of identified phenotypes.

Material and methods. A sample of 203 patients with stable AH aged 50.5 ± 6.9 years underwent CA on two input parameters: glomerular filtration rate and pulse arterial pressure.

Results. Three phenotypes of AH were identified: 1st – preserved renal filtration function and arterial elasticity, 2nd – reduced renal filtration function and arterial elasticity, 3rd – impaired renal filtration function and preserved arterial elasticity. The 2nd phenotype of patients was characterized by the most unfavorable clinical profile.

Conclusion. Performed CA allowed us to identify three clinically significant phenotypes of AH. The combination of reduced renal filtration function and increased arterial stiffness is associated with the maximum cardiovascular risk.

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About the authors

Kirill V. Kuchin

Privolzhsky Research Medical University of the Ministry of Healthcare of Russia

Email: kuchinkv@ya.ru
ORCID iD: 0009-0008-6619-1539

MD, PhD (Medicine), associate professor, associate professor of the Department of internal medicine

Russian Federation, Nizhny Novgorod

Mikhail V. Butusov

Privolzhsky Research Medical University of the Ministry of Healthcare of Russia

Email: misha21082@rambler.ru
ORCID iD: 0009-0002-0742-014X

MD, postgraduate student of the Department of internal medicine

Russian Federation, Nizhny Novgorod

Alexey V. Klemenov

Privolzhsky Research Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: klemenov_av@list.ru
ORCID iD: 0000-0002-3403-0713
SPIN-code: 1559-4472

MD, Dr. Sci. (Medicine), associate professor, professor of the Department of internal medicine

Russian Federation, Nizhny Novgorod

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Supplementary files

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2. Fig. 1. The structure of comorbid pathology in the patients included in the study

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3. Fig. 2. Comparative assessment of the phenotypes of the studied patients by stages of arterial hypertension

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4. Fig. 3. Comparative assessment of the phenotypes of the studied 1 patients according to the degree of arterial hypertension

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5. 4. Comparative assessment of the phenotypes of the studied patients according to the risk of cardiovascular complications of hypertension

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