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Urinary renin-angiotensin markers in polycystic kidney disease
- Source :
- American journal of physiology-Renal physiology, 313(4), F874-F881. AMER PHYSIOLOGICAL SOC
- Publication Year :
- 2017
-
Abstract
- In autosomal dominant polycystic kidney disease (ADPKD), activation of the renin-angiotensin aldosterone system (RAAS) may contribute to hypertension and disease progression. Although previous studies have focused on circulating RAAS components, preliminary evidence suggests that APDKD may increase urinary RAAS components. Therefore, our aim was to analyze circulating and urinary RAAS components in ADPKD. We cross-sectionally compared 60 patients with ADPKD with 57 patients with non-ADPKD chronic kidney disease (CKD). The two groups were matched by sex, estimated glomerular filtration rate (eGFR), blood pressure, and RAAS inhibitor use. Despite similar plasma levels of angiotensinogen and renin, urinary angiotensinogen and renin excretion were five- to sixfold higher in ADPKD ( P < 0.001). These differences persisted when adjusting for group differences and were present regardless of RAAS inhibitor use. In multivariable analyses, ADPKD, albuminuria, and the respective plasma concentrations were independent predictors for urinary angiotensinogen and renin excretion. In ADPKD, both plasma and urinary renin correlated negatively with eGFR. Total kidney volume correlated with plasma renin and albuminuria but not with urinary renin or angiotensinogen excretions. Albuminuria correlated positively with urinary angiotensinogen and renin excretions in ADPKD and CKD. In three ADPKD patients who underwent nephrectomy, the concentrations of albumin and angiotensinogen were highest in plasma, followed by cyst fluid and urine; urinary renin concentrations were higher than cyst fluid. In conclusion, this study shows that, despite similar circulating RAAS component levels, higher urinary excretions of angiotensinogen and renin are a unique feature of ADPKD. Future studies should address the underlying mechanism and whether this may contribute to hypertension or disease progression in ADPKD.
- Subjects :
- Male
Physiology
PATHOGENESIS
030232 urology & nephrology
Angiotensinogen
PROGRESSION
030204 cardiovascular system & hematology
urologic and male genital diseases
Kidney
Pathogenesis
Renin-Angiotensin System
chemistry.chemical_compound
0302 clinical medicine
Renin
Polycystic kidney disease
CONVERTING ENZYME-INHIBITION
Aldosterone
ASSOCIATION
Organ Size
Middle Aged
Polycystic Kidney, Autosomal Dominant
female genital diseases and pregnancy complications
Female
PRORENIN
CREATININE
Glomerular Filtration Rate
Adult
medicine.medical_specialty
RENAL-FUNCTION
hypertension
Urinary system
Autosomal dominant polycystic kidney disease
Renal function
ALDOSTERONE SYSTEM
MECHANISMS
03 medical and health sciences
Internal medicine
Renin–angiotensin system
medicine
Humans
Renal Insufficiency, Chronic
Aged
Creatinine
aldosterone
business.industry
urogenital system
medicine.disease
intrarenal renin-angiotensin system
Endocrinology
Cross-Sectional Studies
chemistry
business
chronic kidney disease
Biomarkers
Subjects
Details
- ISSN :
- 15221466 and 1931857X
- Volume :
- 313
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- American journal of physiology. Renal physiology
- Accession number :
- edsair.doi.dedup.....bde89e883c01ba3087167f74fa65a22d