Microalbuminuria and increased plasma prorenin. Prevalence in diabetics followed up for four years

Luetscher, John A.; Kraemer, Fredric B.

doi:10.1001/archinte.148.4.937

Cited by 14 publications

(9 citation statements)

References 19 publications

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“…The observation that the mean concentration of serum total renin was significantly (P < 0.05) higher in patients having microalbuminuria when compared with normoalbuminuric patients is consistent with earlier reports of Amemiya et al (10) and Luetscher and Kraemer (11). In the report of Amemiya et al, 11 microalbuminuric IDDM patients had significantly higher concentrations of total renin than did 55 normoalbuminuric IDDM patients.…”

Section: Conclusion-supporting

confidence: 87%

“…Synthesis and secretion of prorenin also occur at various extrarenal sites (6)(7)(8) and have also been associated with local synthesis of angiotensin II in the blood vessel wall (9). Increased prorenin values have been known to be associated with diabetic micro vascular complications, such as microalbuminuria (10,11) and proliferative retinopathy (12). Even more, an increased prorenin concentration in plasma has been suggested to predict the development of diabetic nephropathy and retinopathy (13) within a few years of detection.…”

mentioning

confidence: 99%

“…Because earlier reports demonstrated an association between elevated prorenin concentrations and microalbuminuria (10,11), we wanted to evaluate whether elevated total renin concentrations in serum in insulin-dependent diabetes mellitus (IDDM) patients could be used in screening for incipient diabetic nephropathy.…”

mentioning

confidence: 99%

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Elevated Serum Total Renin Is Insensitive in Detecting Incipient Diabetic Nephropathy

Matinlauri

Rönnemaa²,

Koskinen³

et al. 1995

Diabetes Care

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Section: Conclusion-supporting

confidence: 87%

mentioning

confidence: 99%

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Elevated Serum Total Renin Is Insensitive in Detecting Incipient Diabetic Nephropathy

Matinlauri

Rönnemaa²,

Koskinen³

et al. 1995

Diabetes Care

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“…Several cross-sectional studies have demonstrated that normotensive adults with microvascular complications of diabetes have higher plasma prorenin activity than patients free of complications [16,[28][29][30]. Even in children and adolescents it has been described that elevated plasma prorenin is associated with early nephropathy, as detected by persistent microalbuminuria [31,32].…”

Section: Discussionmentioning

confidence: 99%

Plasma prorenin levels may predict persistent microalbuminuria in children with diabetes

Chiarelli

Pomilio

Luca

et al. 2001

Pediatric Nephrology

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Diabetic microangiopathy is characterized by increased prorenin concentrations. In the present study, we evaluated plasma prorenin concentrations in a large group of adolescents with onset of diabetes during childhood to determine whether increasing prorenin levels may predict the development of persistent microalbuminuria. Ninety-seven young diabetic patients were studied; they were divided according to the presence of persistent microalbuminuria, at the end of follow-up, into group A and group B (patients who did not develop and who developed persistent microalbuminuria, respectively). One hundred and two healthy subjects, matched for age and sex, were also selected. Patients were followed up for at least 10 years. At the beginning of the study there were no significant differences in prorenin levels between either the two diabetic groups or the healthy controls. During follow-up, an increase in plasma prorenin started at 4 years and became statistically significant (P<0.01) 3 years before the onset of persistent microalbuminuria. No correlation was found between plasma prorenin levels and HbAlc percentages. In conclusion, an increased concentration of prorenin in plasma precedes the elevation of albumin excretion rate (AER) and, therefore, can be useful for identifying patients with onset of diabetes during childhood at risk of developing incipient nephropathy later in life.

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“…the same group that first identified prorenin went on to show that patients with diabetes mellitus can have markedly elevated circulating levels of prorenin, even when plasma renin activity is low. [25][26][27] moreover, prorenin plasma levels correlated directly with diabetic complications whereas plasma renin activity did not. much of the pathology in both the kidney and the eye in patients with diabetes mellitus seems attributable to prorenin.…”

Section: Mechanistic Considerationsmentioning

confidence: 91%

Direct renin inhibition and the kidney

Hollenberg

2009

Nat Rev Nephrol

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Direct renin inhibition is a new means for blocking the renin-angiotensin system at the rate-limiting step of the cascade of events triggered by renin release--the interaction of renin with its physiological substrate angiotensinogen. The remarkable success of angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers in the management of cardiovascular and renal disease has led to great interest in the potential of direct renin inhibitors. This Review focuses on the evidence that suggests that direct renin inhibitors might block the renin-angiotensin system in the kidney more completely than either angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers. The therapeutic implications of this evidence are also reviewed, as well as the possible mechanistic routes by which direct renin inhibition might exert its influence on the kidney.

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Microalbuminuria and increased plasma prorenin. Prevalence in diabetics followed up for four years

Cited by 14 publications

References 19 publications

Elevated Serum Total Renin Is Insensitive in Detecting Incipient Diabetic Nephropathy

Elevated Serum Total Renin Is Insensitive in Detecting Incipient Diabetic Nephropathy

Plasma prorenin levels may predict persistent microalbuminuria in children with diabetes

Direct renin inhibition and the kidney

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