Plasma and Urinary Levels of Adrenomedullin in Chronic Glomerulonephritis Patients with Proteinuria

Abstract

In this study, we measured levels of plasma and urinary adrenomedullin (AM) in 37 patients with chronic glomerulonephritis including minimal change nephrotic syndrome, focal segmental glomerulosclerosis or membranous nephropathy that can induce severe proteinuria. Thirty-nine healthy volunteers were enrolled as controls. Plasma and urinary AM levels were measured by an AM-specific radioimmunoassay. Plasma AM concentrations were higher and urinary AM levels were lower in patients with chronic glomerulonephritis than in healthy volunteers. Patients were divided into two groups according to urinary excretion of protein for 24 h (UPro, g/day) which reflects the disease activity or glomerular damage of the glomerulonephritis (group I: Upro < 1, group II: Upro ≥ 1). Plasma AM levels positively and urinary AM-levels negatively correlated with the degree of proteinuria. These results suggest that plasma and urinary AM levels in patients with chronic glomerulonephritis reflect the disease activity or glomerular damage represented by the degree of proteinuria.

Haplotype-Based Case-Control Study Revealing an Association between the Adrenomedullin Gene and Proteinuria in Subjects with Essential Hypertension

“…The investigators themselves pointed out that the frequency of the 19-repeat allele of the microsatellite was not increased in hypertensive diabetic patients without nephropathy, which decreases the likelihood that the relationship between the 19-repeat allele and diabetic nephropathy is mediated by a predisposition to hypertension. AM has been reported to play a renoprotective role in chronic hypertensive renal failure (28), and the plasma and urinary AM levels in patients with chronic glomerulonephritis have been shown to reflect the disease activity or glomerular damage represented by the degree of PU (29). Overall these results suggest that AM is involved in the pathophysiology of renal function or PU.…”

Midregional Proadrenomedullin for Prediction of Cardiovascular Events in Coronary Artery Disease: Results from the AtheroGene Study

“…In a clinical setting, ADM concentrations are increased in congestive heart failure (7, 8 ), acute myocardial infarction (7 ), hypertension (29 ), chronic renal failure (30 ), chronic glomerulonephritis (31 ), and sepsis (32 ).…”

Adrenomedullin and Its Role in Renal Diseases

“…In this study, plasma AM was positively correlated and urinary AM was negatively correlated with the degree of proteinuria. Thus, both plasma and urinary AM concentrations may reflect the disease activity or glomerular damage represented by the degree of proteinuria in these patients [84]. …”

“…In series including a variety of glomerular histological findings, the plasma AM levels seem to depend upon a proportion of patients included with nephrotic syndrome or the severity of urinary proteinuria. Plasma AM correlated with urinary proteinuria in one series [84]and negatively with plasma renin activity and aldosterone concentration in another series [85], indicative of the participation of plasma AM in disorders of body fluid volume. The discrepancy of plasma AM levels in chronic glomerulonephritis may be explained by the pathophysiological and histological heterogeneity of the patient subgroups included in the two series.…”