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- Title
Comparison of intrarenal renin-angiotensin system activity in diabetic versus non-diabetic patients with overt proteinuria.
- Authors
Park, Ji Hyeon; Jang, Hye Ryoun; Lee, Jong‐Ho; Lee, Jung Eun; Huh, Wooseong; Lee, Kyu‐Beck; Kwon, Young‐Joo; Do, Jun Young; Kim, Hye Young; Kim, Yoon‐Goo
- Abstract
Aim The intrarenal renin-angiotensin system ( RAS) has been reported to be activated in chronic proteinuria patients. This study aimed to compare intrarenal RAS activity between diabetic nephropathy ( DN) and non-diabetic nephropathy ( NDN) patients with overt proteinuria. Methods A multicenter, cross-sectional study was conducted in 116 patients with overt proteinuria (urinary protein/creatinine ratio [u PCR] > 1 mg/mg Cr). To estimate intrarenal RAS activity we measured urinary excretion of angiotensinogen ( uAGT) and renin (u Renin) in patients with DN ( n = 38) and NDN ( n = 78). Results Both natural logarithms of uAGT/urinary creatinine (ln[ uAGT/ uCr]) and u Renin (ln[ uRenin/ uCr]) levels were significantly higher in patients with DN compared with those with NDN (ln[ uAGT/ uCr]: 4.16 ± 1.13 in DN vs. 3.52 ± 1.21 in NDN, P = 0.007; ln[ uRenin/ uCr]: 5.66 ± 1.60 in DN vs. 4.29 ± 1.48 in NDN, P < 0.001), when estimated glomerular filtration rate ( eGFR) and u PCR showed no significant difference between the two groups. In a subgroup analysis, according to amount of proteinuria, both uAGT and u Renin were higher in DN in patients with subnephrotic-range proteinuria ( uPCR < 3.5 mg/mg Cr). However, in patients with nephrotic-range proteinuria ( uPCR ≥ 3.5 mg/mg Cr), only u Renin was higher in DN compared to NDN. In a multiple regression analysis, diabetes showed independent association with u Renin. Conclusion Consistently elevated u Renin in DN, regardless of the amount of proteinuria, indicates that intrarenal RAS activity may be higher in DN compared to NDN in patients with overt proteinuria.
- Subjects
RENIN-angiotensin system; PEOPLE with diabetes; PROTEINURIA; CREATININE; GLOMERULAR filtration rate; PATIENTS
- Publication
Nephrology, 2015, Vol 20, Issue 4, p279
- ISSN
1320-5358
- Publication type
Article
- DOI
10.1111/nep.12383