Background and Aims:
Albuminuria is an indicator of cardiovascular (CV) risk and often develops in hypertensive patients, despite of being under chronic suppression of renin-angiotensin system (RAS).  Novel tools are demanded to anticipate albuminuria development and avoid a bad CV and renal prognosis. The aim is the identification of new markers able to predict albuminuria in hypertensives.

Methods:
Urine samples were collected from 53 hypertensives patients under RAS suppression classified according to their albumin/creatinine ratio (ACR) in: A) Control (ACR <10mg/g) (no albuminuria development is expected), B) Normo-high (NH) (ACR 10-30mg/g) who will progress or not to microalbuminuria, and C) Microalbuminuric (ACR 30-200mg/g). Clinical follow-up was performed, albuminuria progression evaluated and urine samples collected after 6 months and one year. The urinary proteome and metabolome were analyzed by isobaric labeling (TMT) and target mass spectrometry (LC-MS/MS).  Altered proteins and metabolites were identified in early albuminuria and their predictive potential was evaluated.

Results
A total of 2709 proteins were identified, 481 showing differential abundance in NH versus control group (301 increased; 180 decreased).  Based on sensitivity and reproducibility, 51 proteins were selected pointing to immune response, coagulation system and metabolism. CVrisk metabolites previously identified by our group also showed variation linked to albuminuria.

Conclusions:
We have identified a urinary molecular profile able to reflect sub-clinical differences in hypertensive patients in normo-albuminuria condition. This panel, pending further confirmation, will allow a prompt and more efficient intervention in patients who are currently under no particular supervision beyond blood pressure control.

02 - A URINARY FINGERPRINT REFLECTS SUB-CLINICAL ALBUMINURIA AND CARDIOVASCULAR RISK IN HYPERTENSIVE PATIENTS UNDER CHRONIC BLOOD PRESSURE CONTROL.