Urinary angiotensinogen is correlated with blood pressure in men (Bogalusa Heart Study)

Kobori, Hiroyuki; Urushihara, Maki; Xu, Ji; Berenson, Gerald S.; Navar, L. Gabriel

doi:10.1097/hjh.0b013e3283392673

Cited by 63 publications

(77 citation statements)

References 76 publications

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“…By a positive feedback mechanism, Ang II increased AGT expression within the kidney, which subsequently led to additional increase of intratubular Ang II formation (18). In agreement with the concept that UAGT reflects intrarenal activation of the RAS, UAGT was found to correlate with high BP (20). Furthermore, inhibitors of the RAS are associated with reduced UAGT excretion (19).…”

Section: Discussionsupporting

confidence: 70%

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Reversibility of the Effects of Aliskiren in the Renal Versus Systemic Circulation

Schneider

Janka

Ziegler

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Renal hemodynamic effects of inhibitors of the renin-angiotensin system can increase the risk of acute kidney injury under certain conditions. The BP-lowering effects of the renin inhibitor aliskiren are sustained 3-4 weeks after withdrawal. In this study, the reversibility of the renal hemodynamic effects of aliskiren was tested. Design, setting, participants, & measurementsIn this open-label study, renal perfusion was measured by 1.5-T magnetic resonance imaging-arterial spin labeling in 34 subjects with arterial hypertension before aliskiren (prealiskiren), after 4 weeks of aliskiren treatment (300 mg), and 4-5 days (;2.5-3.03 plasma half-life) after withdrawal (post-aliskiren).Results Aliskiren reduced systolic BP from 152 6 14 to 139 6 16 mmHg (P,0.0001), which was sustained postaliskiren (136 6 13 mmHg, P=1.00 versus aliskiren). Aliskiren significantly altered renal perfusion (P=0.005), increasing from 272 6 25 pre-aliskiren to 287 6 29 ml/min per 100 g during aliskiren (P=0.03). This increase in renal perfusion was completely reversed post-aliskiren (272 6 26 ml/min per 100 g, P=0.03 versus aliskiren, P=0.63 versus pre-aliskiren). No changes were noted in urinary angiotensinogen levels. Plasma renin activity was reduced by aliskiren, which was sustained post-aliskiren. Angiotensin II and aldosterone were reduced by aliskiren but recovered post-aliskiren to pre-aliskiren levels.Conclusions After withdrawal of aliskiren, the effects on BP were sustained, whereas increase in renal perfusion was reversed, which was associated with recovery of angiotensin II and aldosterone to pretreatment levels. Renal hemodynamic effects are more readily reversible than systemic effects of aliskiren.

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Section: Discussionsupporting

confidence: 70%

“…In the current study, we found no significant effect of ALI on UAGT. Previous studies, however, showed a large variation of this measurement (19,20), and our study may have simply been underpowered to detect a significant effect of ALI on this parameter.…”

Section: Discussionmentioning

confidence: 66%

Reversibility of the Effects of Aliskiren in the Renal Versus Systemic Circulation

Schneider

Janka

Ziegler

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…Many clinical studies also showed that urinary AGT level and prognosis might be correlated in patients with amyloidosis, DM, hypertension, renal transplantation, preeclampsia, IgAN, and chronic kidney disease (20,22,(32)(33)(34)(35)(36)(37)(38) A study on renal transplant patients with a mean proteinuria less than 1 g/day reported that basal urine AGT level was BP: Blood pressure, UP/Ucre: Urine protein-to-creatinine ratio, UAGT/Ucre: Urine angiotensinogen-to-creatinine ratio, LDL: Low-density lipoprotein, HDL: High-density lipoprotein, GFR: Glomerular filtration rate, CRP: C-reactive protein.…”

Section: Turk Neph Dial Transpl 2015; 24 (2): 195-201mentioning

confidence: 99%

The Relationship Between Proteinuria and Urinary Angiotensinogen Levels in Patients with Nephrotic Syndrome

Bayrakci¹,

Ozkayar²,

Ateş³

et al. 2015

Turk Neph Dial Transpl

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OBJECTIVE:Recently, urinary angiotensinogen (AGT) is used frequently as a marker of intrarenal renin-angiotensin-aldosterone system (RAAS) activity. In this study, we aimed to investigate the relationship between urinary AGT and proteinuria in patients with nephrotic syndrome. MATERIAL and METHODS:Twenty-four patients followed up with nephrotic syndrome were included. The patients diagnosed with vasculitis, lupus nephritis, diabetes mellitus or amyloidosis, those with a glomerular filtration rate (GFR) <90 ml/min/1.73 m2, and patients receiving RAAS inhibitors, aldosterone receptor antagonists, diuretics or immunosuppressive drugs were excluded. Urinary AGT was calculated as AGT-to-creatinine ratio and proteinuria was calculated as protein-to-creatinine ratio (UP/Ucre) (mg/mg). Logarithmic transformations of UAGT/Ucre and UP/Ucre values were calculated to obtain the normal distributions. RESULTS:Log(UP/Ucre) was 2.9±0.9, and log(UAGT/Ucre) was 0.7±0.2. There was a strong positive correlation between log(UP/Ucre) and log(UAGT/Ucre) (r=0.783, p<0.001). The strong correlation between log(UP/Ucre) and log(UAGT/Ucre) remained when controlled for the effects of 24-hour mean systolic and diastolic blood pressures (r=0.752, p=0.001). CONCLUSION:We found a strong correlation between proteinuria and urinary AGT levels. Different from the previous studies, GFR was >90 ml/min in all patients. Therefore, high urinary AGT levels in earlier stages of nephrotic syndrome may reflect intrarenal RAAS activity that is supposed to play a role in pathogenesis of the disease. KEY WORDS:Urinary angiotensinogen, Proteinuria, Nephrotic syndrome ÖZ AMAÇ: Son yıllarda idrar anjiyotensinojen (AGT) düzeyi, intrarenal renin-anjiyotensin-aldosteron sistemi (RAAS) aktivitesinin göstergelerinden birisi olarak sıkça kullanılmaktadır. Biz çalışmada nefrotik sendromlu hastalarda idrar AGT ve proteinüri düzeyi arasındaki ilişkiyi incelemeyi amaçladık. GEREÇ ve YÖNTEMLER:Çalışmaya nefrotik sendromlu 24 hasta dahil edildi. Vaskülit, lupus nefriti, diyabetes mellitus veya amiloidoz tanılı, glomerüler filtrasyon hızı (GFH)<90 ml/dk/1,73 m2 olan, RAAS inhibitörü, aldosteron reseptör antagonisti, diüretik veya immünsupresif ilaç kullanan hastalar çalışma dışı bırakıldı. AGT atılımı, AGT/kreatinin oranı (UAGT/Ucre) (µg/gr); proteinüri, protein/kreatinin oranı (UP/Ucre) (mg/mg) olarak hesaplandı. Normal dağılımı sağlamak amacıyla UAGT/Ucre ve UP/Ucre parametreleri logaritmik dönüşümleri yapılarak değerlendirmeye alındı.BULGULAR: Log(UP/Ucre):2,9±0,9, log(UAGT/Ucre): 0,7±0,2 saptandı. 24 saatlik ortalama sistolik ve diyastolik kan basınçlarının etkisi kontrol altında tutulduğunda log(UP/Ucre) ile log(UAGT/Ucre) arasındaki korelasyonun güçlü bir şekilde pozitif yönde devam ettiği görüldü (r:0,752, p=0,001).SONUÇ: Çalışmamızda, proteinüri ve idrar AGT düzeyleri arasında güçlü korelasyon saptanmıştır. Önceki çalışmalardan farklı olarak hastaların tümünde GFH≥90 ml/dk/1,73 m2 idi. Bu durum nefrotik sendromda erken dönemde de yüksek saptanabilen idrar AG...

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“…Renin is produced by the cells of the juxtaglomerular apparatus cells and then delivered in the renal interstitium and vascular compartment resulting local generation of angiotensin. Angiotensin-converting enzyme is abundant in the kidney and is present in the proximal tubules, distal tubules, and collecting ducts (Kobori, 2010). Angiotensin I delivered to the kidney can also be converted to angiotensin II (Komlosi, 2003).…”

mentioning

confidence: 99%

“…All of the components necessary to generate intrarenal angiotensin II are present along the nephron (Navar, 2002;Kobori, 2007). Recently, in the Bogalusa Heart Study was proved that urinary level of angiotensinogen can be a new and potential marker of intrarenal RAS status in kidney disease due to arterial hypertension (Kobori, 2010). An important role in progression of inflammation and fibrosis seems to involve the renin-angiotensin system, and specifically the angiotensin-converting enzyme (ACE)-angiotensin (Ang) II-AT 1 receptor axis.…”

mentioning

confidence: 99%

Arterial Hypertension and Renal Disease

Şerban¹,

Mihăescu²,

Noveanu³

et al. 2012

Diseases of Renal Parenchyma

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Urinary angiotensinogen is correlated with blood pressure in men (Bogalusa Heart Study)

Cited by 63 publications

References 76 publications

Reversibility of the Effects of Aliskiren in the Renal Versus Systemic Circulation

Reversibility of the Effects of Aliskiren in the Renal Versus Systemic Circulation

The Relationship Between Proteinuria and Urinary Angiotensinogen Levels in Patients with Nephrotic Syndrome

Arterial Hypertension and Renal Disease

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Urinary angiotensinogen is correlated with blood pressure in men (Bogalusa Heart Study)

Cited by 63 publications

References 76 publications

Reversibility of the Effects of Aliskiren in the Renal Versus Systemic Circulation

Reversibility of the Effects of Aliskiren in the Renal Versus Systemic Circulation

The Relationship Between Proteinuria and Urinary Angiotensinogen ￼Levels in Patients with Nephrotic Syndrome

Arterial Hypertension and Renal Disease

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The Relationship Between Proteinuria and Urinary Angiotensinogen Levels in Patients with Nephrotic Syndrome