Urinary angiotensinogen and urinary sodium are associated with blood pressure in normoalbuminuric children with diabetes

Sołtysiak, Jolanta; Skowrońska, Bogda; Fichna, Piotr; Ostalska‐Nowicka, Danuta; Stankiewicz, Witold; Lewandowska-Stachowiak, Maria; Lipkowska, Katarzyna; Zachwieja, Jacek

doi:10.1007/s00467-014-2861-0

Cited by 18 publications

(12 citation statements)

References 39 publications

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“…Notably, the AGT level was not increased in the plasma of the patients. Additionally, a recent study has reported that urinary AGT levels were significantly increased and positively correlated with blood pressure in prehypertensive patients with type 1 diabetes mellitus [64]. Further, the urinary sodium excretion values were negatively correlated with blood pressure, urinary AGT, the albumin-creatinine ratio, and estimated glomerular filtration rate (eGFR).…”

Section: Urinary Agt As a New Biomarker Of Intrarenal Ras Status In Omentioning

confidence: 91%

Role of the intrarenal renin–angiotensin system in the progression of renal disease

Urushihara

Kubo

2016

Pediatr Nephrol

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The intrarenal renin-angiotensin system (RAS) has many well-documented pathophysiologic functions in both blood pressure regulation and renal disease development. Angiotensin II (Ang II) is the major bioactive product of the RAS. It induces inflammation, renal cell growth, mitogenesis, apoptosis, migration, and differentiation. In addition, Ang II regulates the gene expression of bioactive substances and activates multiple intracellular signaling pathways that are involved in renal damage. Activation of the Ang II type 1 (AT1) receptor pathway results in the production of proinflammatory mediators, intracellular formation of reactive oxygen species, cell proliferation, and extracellular matrix synthesis, which in turn facilities renal injury. Involvement of angiotensinogen (AGT) in intrarenal RAS activation and development of renal disease has previously been reported. Moreover, studies have demonstrated that the urinary excretion rates of AGT provide a specific index of the intrarenal RAS status. Enhanced intrarenal AGT levels have been observed in experimental models of renal disease, supporting the concept that AGT plays an important role in the development and progression of renal disease. In this review, we focus on the role of intrarenal RAS activation in the pathophysiology of renal disease. Additionally, we explored the potential of urinary AGT as a novel biomarker of intrarenal RAS status in renal disease.

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Section: Urinary Agt As a New Biomarker Of Intrarenal Ras Status In Omentioning

confidence: 91%

Role of the intrarenal renin–angiotensin system in the progression of renal disease

Urushihara

Kubo

2016

Pediatr Nephrol

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“…Zhuang et al [ 70 ] have shown that elevated urinary angiotensinogen levels precede the onset of albuminuria in patients with type 2 diabetes. Similarly, urinary angiotensinogen and sodium excretions are significantly increased in normo-albuminuric children with diabetes [ 71 ]. These data suggest that enhanced urinary angiotensinogen levels in patients with proteinuria cannot be simply explained by a non-specific consequence of proteinuria.…”

Section: Urinary Angiotensinogen As a Biomarker Of Intrarenal Raas Anmentioning

confidence: 99%

Independent regulation of renin–angiotensin–aldosterone system in the kidney

2018

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Renin–angiotensin–aldosterone system (RAAS) plays important roles in regulating renal hemodynamics and functions, as well as in the pathophysiology of hypertension and renal disease. In the kidney, angiotensin II (Ang II) production is controlled by independent multiple mechanisms. Ang II is compartmentalized in the renal interstitial fluid with much higher concentrations than those existing in the circulation. Inappropriate activation of the intrarenal RAAS is an important contributor to the pathogenesis of hypertension and renal injury. It has been revealed that intrarenal Ang II levels are predominantly regulated by angiotensinogen and therefore, urinary angiotensinogen could be a biomarker for intrarenal Ang II generation. In addition, recent studies have demonstrated that aldosterone contributes to the progression of renal injury via direct actions on glomerular podocytes, mesangial cells, proximal tubular cells and tubulo-interstitial fibroblasts through the activation of locally expressed mineralocorticoid receptor. Thus, it now appears that intrarenal RAAS is independently regulated and its inappropriate activation contributes to the pathogenesis of the development of hypertension and renal disease. This short review article will focus on the independent regulation of the intrarenal RAAS with an emphasis on the specific role of angiotensinogen.

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“…However, an increase in urinary AGT appears earlier than an increase in urinary Alb in diabetes. Others [ 33 ] and we [ 16 ] previously reported that an increase in urinary AGT is observed in normoalbuminuric children with type 1 diabetes. In addition, we reported that an increase in urinary AGT precedes an increase in urinary Alb in experimental type 1 diabetes [ 34 ].…”

Section: Discussionmentioning

confidence: 65%

Urinary Angiotensinogen Could Be a Prognostic Marker of Renoprotective Effects of Alogliptin in Patients with Type 2 Diabetes

Mizushige

Kobori

Nishijima

et al. 2015

Journal of Diabetes Research

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Background. The aims of this study were (1) to examine the renoprotective effects of alogliptin and (2) to establish urinary angiotensinogen (AGT) as a prognostic marker of renoprotective effects of alogliptin in patients with type 2 diabetes (T2D). Methods. In 43 patients with T2D (18 women, 66.1 ± 1.71 years), 25 mg/day of alogliptin was added to the traditional hypoglycemic agents and/or nondrug treatments. Urinary concentrations of albumin (Alb) and AGT, normalized by urinary concentrations of creatinine (Cr) (UAlbCR and UAGTCR, respectively), were measured before and after the 12-week alogliptin treatment. Results. Alogliptin treatment tended to decrease UAlbCR (99.6 ± 26.8 versus 114.6 ± 36.0 mg/g Cr, P = 0.198). Based on % change in UAlbCR, patients were divided into two groups, responders (<−25%) and nonresponders (≥−25%), and a logistic analysis of UAGTCR before treatment showed cutoff value of 20.8 µg/g Cr. When all patients were redivided into two groups, those with higher values of UAGTCR before the treatment (Group H, n = 20) and those with lower values (Group L), Group H showed significantly decreased UAlbCR in response to alogliptin (−14.6 ± 8.6 versus +22.8 ± 16.8%, P = 0.033). Conclusion. Urinary AGT could be a prognostic marker of renoprotective effects of alogliptin in patients with T2D.

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Urinary angiotensinogen and urinary sodium are associated with blood pressure in normoalbuminuric children with diabetes

Cited by 18 publications

References 39 publications

Role of the intrarenal renin–angiotensin system in the progression of renal disease

Role of the intrarenal renin–angiotensin system in the progression of renal disease

Independent regulation of renin–angiotensin–aldosterone system in the kidney

Urinary Angiotensinogen Could Be a Prognostic Marker of Renoprotective Effects of Alogliptin in Patients with Type 2 Diabetes

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