Increased urinary Angiotensinogen/Creatinine (AGT/Cr) ratio may be associated with reduced renal function in autosomal dominant polycystic kidney disease patients

BMC Nephrology

Curie Ahn¹  Young-Hwan Hwang³  Hae Il Cheong²  Jung Woo Noh⁵  Seung Hyup Kim⁴  Kook-Hwan Oh¹  Miyeun Han¹  Hyunsuk Kim¹  Joon Young Jang⁶  Ah-Young Kang⁶  Hayne Cho Park⁷ 

[1]Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul 110-744, South Korea

[2]Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, South Korea

[3]Department of Internal Medicine, Eulji University College of Medicine, Seoul, South Korea

[4]Department of Radiology, Seoul National University Hospital, Seoul, South Korea

[5]Department of Internal Medicine, Hallym University College of Medicine, Seoul, South Korea

[6]Transplantation Research Institute, Seoul National University, Seoul, South Korea

[7]Research Coordination Center for Rare Diseases, Seoul National University Hospital, Seoul, South Korea

关键词: Renin-angiotensin system;    Renal function;    Biomarkers;    Autosomal dominant polycystic kidney disease;    Angiotensinogen;   

Others  :  1220058
DOI  :  10.1186/s12882-015-0075-8

 received in 2014-10-21, accepted in 2015-05-21,  发布年份 2015

【 摘 要 】

Background

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary kidney diseases that frequently result in renal failure. In this cross-sectional observational cohort study, we evaluated urinary angiotensinogen (AGT) as a potential biomarker to assess renal function in ADPKD.

Methods

Urinary AGT was measured in 233 ADPKD patients and its association with estimated glomerular filtration rate (eGFR) and height-adjusted total kidney volume (htTKV) were evaluated. The localization of AGT and other renin-angiotensin system (RAS)-related molecules were identified using immunohistochemistry in human ADPKD tissues.

Results

Baseline urinary AGT/Cr was negatively correlated with CKD-EPI eGFR (r ²   = 0.162, P < 0.001) and positively correlated with htTKV (r ²  = 0.107, P < 0.001). Both urinary AGT/Cr and plasma renin activity levels were significantly elevated in hypertensive ADPKD patients. Among hypertensive subjects, urinary AGT/Cr was significantly increased in the advanced CKD stages (III-V) compared to early CKD stages (I-II) (28.6 ± 60.3 vs. 93.2 ± 139.3 μg/g, P < 0.001). Immunohistochemical study showed strong expression of AGT along the cyst-lining epithelial cells as well as the nearby compressed tubular epithelial cells.

Conclusions

Our results suggested that urinary AGT/Cr may be a valuable biomarker for renal damage in ADPKD since intrarenal ischemic insults induced by cyst growth and subsequent intrarenal RAS activation may play a potential role in the development of hypertension and renal dysfunction in ADPKD.

【 授权许可】

   
2015 Park et al.

【 图 表 】

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