Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients
Yıl: 2019 Cilt: 28 Sayı: 1 Sayfa Aralığı: 17 - 23 Metin Dili: İngilizce DOI: 10.5152/turkjnephrol.2019.3101 İndeks Tarihi: 21-07-2020
Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients
Öz: Objective: Several studies have shown that local renin–angiotensin system (RAS) activity in the kidneys may play a role inthe pathogenesis of hypertension and kidney damage in patients with chronic kidney disease. In this study, we aimed toinvestigate the effect of local RAS activity on hypertension and residual renal function (RRF) in patients undergoing peritoneal dialysis (PD).Materials and Methods: Fifty patients with residual urine undergoing PD were included in the study. They were dividedinto the hypertensive (n=30) and non-hypertensive (n=20) groups. The urine angiotensinogen-to-creatinine ratio, which isan indicator of local RAS activity, was compared between the two groups. Factors affecting this ratio were also investigated.Results: There was no significant difference in the mean urine angiotensinogen-to-creatinine ratios between the twogroups. A correlation analysis revealed that the urine angiotensinogen-to-creatinine ratio had a significant negative correlation with RRF determined by 24-hour creatinine excretion (r=−0.391, p=0.005). There was a positive correlation betweenthe urine angiotensinogen-to-creatinine ratio with proteinuria (r=0.289, p=0.04) and negative correlation with serum albumin (r=−0.280, p=0.049). However, we could not find any association between the urine angiotensinogen-to-creatinine ratioand blood pressure values.Conclusion: Local RAS activation in the kidney reflected by urinary angiotensinogen is associated with RRF and proteinuriain patients undergoing PD; however, high blood pressure was not correlated with urinary angiotensinogen levels.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Lameire N, Bernaert P, Lambert MC, Vijt D. Cardiovascular risk factors and their management in patients on continuous ambulatory peritoneal dialysis. Kidney Int Suppl 1994; 48: S31-S38.
- 2. Rocco MV, Flanigan MJ, Beaver S, Frederick P, Gentile DE, McClellan WM, et al. Report from the 1995 Core Indicators for Peritoneal Dialysis Study Group. Am J Kidney Dis 1997; 30: 165-73. [CrossRef]
- 3. Ortega LM, Materson BJ. Hypertension in peritoneal dialysis patients: epidemiology, pathogenesis and treatment. J Am Soc Hypertens 2001; 5: 128-36. [CrossRef]
- 4. Cocchi R, Degli Esposti E, Fabbri A, Lucatello A, Sturani A, Quarello F, et al. Prevalence of hypertension in patients on peritoneal dialysis: results of an Italian multicentre study. Nephrol Dial Transplant 1999; 14: 1536-40. [CrossRef]
- 5. Menon MK, Naimark DM, Bargman JM, Vas SI, Oreopoulos DG. Long-term blood pressure control in a cohort of peritoneal dialysis patients and its association with residual renal function. Nephrol Dial Transplant 2001; 16: 2207-13. [CrossRef]
- 6. Weir MR, Dzau VJ. The renin angiotensin aldosterone system: a specific target for hypertension management. Am J Hypertens 1999; 12: 205S-213S. [CrossRef]
- 7. Rohrwasser A, Morgan T, Dillon HF, Zhao L, Callaway CW, Hillas E, et al. Elements of a paracrine tubular renin angiotensin system along the entire nephron. Hypertension 1999; 34: 1265-74. [CrossRef]
- 8. Lantelme P, Rohrwasser A, Gociman B, Hillas E, Cheng T, Petty G, et al. Effects of dietary sodium and genetic background on angiotensinogen and renin in mouse. Hypertension 2002; 39: 1007-14. [CrossRef]
- 9. Kobori H, Nishiyama A, Harrison-Bernard LM, Navar LG. Urinary angiotensinogen as an indicator of intrarenal angiotensin status in hypertension. Hypertension 2003; 41: 42-9. [CrossRef]
- 10. Aybal Kutlugun A, Altun B, Buyukasik Y, Aki T, Turkmen E, et al. Elevated urinary angiotensinogen a marker of intrarenal renin angiotensin system in hypertensive renal transplant recipients: does it play a role in development of proteinuria in hypertensive renal transplant patients? Transpl Int 2012; 25: 13-8.[CrossRef]
- 11. Kobori H, Nangaku M, Navar LG, Nishiyama A. The intrarenal renin-angiotensin system: from physiology to the pathobiology of hypertension and kidney disease. Pharmacol Rev 2007; 59: 251-87 [CrossRef]
- 12. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, et al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension 2005; 45: 142-61. [CrossRef]
- 13. Katsurada A, Hagiwara Y, Miyashita K, Satou R, Miyata K, Ohashi N, et al. Novel sandwich ELISA for human angiotensinogen. Am J Physiol Renal Physiol 2007; 293: F956-F960. [CrossRef]
- 14. Kinoshita Y, Kondo S, Urushihara M, Suga K, Matsuura S, Takamatsu M, et al. Angiotensin II type 1 receptor blockade suppresses glomerular renin-angiotensin system activation, oxidative stress, and progressive glomerular injury in rat anti-glomerular basement membrane glomerulonephritis. Transl Res 2011; 158: 235-48. [CrossRef]
- 15. Mezzano SA, Ruiz-Ortega M, Egido J. Angiotensin II and renal fibrosis. Hypertension 2001; 38: 635-8. [CrossRef]
- 16. Yamamoto T, Nakagawa T, Suzuki H, Ohashi N, Fukasawa H, Fujigaki Y, et al. Urinary angiotensinogen as a marker of intrarenal angiotensin II activity associated with deterioration of renal function in patients with chronic kidney disease. J Am Soc Nephrol 2007; 18: 1558-65. [CrossRef]
- 17. Kobori H, Ohashi N, Katsurada A, Miyata K, Satou R, Saito T, Yamamoto T: Urinary angiotensinogen as a potential biomarker of severity of chronic kidney diseases. J Am Soc Hypertens 2008; 2: 349-54. [CrossRef]
- 18. Nishiyama A, Konishi Y, Ohashi N, Morikawa T, Urushihara M, Maeda I, et al. Urinary angiotensinogen reflects the activity of intrarenal renin-angiotensin system in patients with IgA nephropathy. Nephrol Dial Transplant 2011; 26: 170-7. [CrossRef]
- 19. Kim YG, Song SB, Lee SH, Moon JY, Jeong KH, Lee TW, et al. Urinary angiotensinogen as a predictive marker in patients with immunoglobulin A nephropathy. Clin Exp Nephrol 2011; 15: 720-6. [CrossRef]
- 20. Mills KT, Kobori H, Hamm LL, Alper AB, Khan IE, Rahman M, et al. Increased urinary excretion of angiotensinogen is associated with risk of chronic kidney disease. Nephrol Dial Transplant 2012; 27: 3176-81. [CrossRef]
- 21. Kim SM, Jang HR, Lee YJ, Lee JE, Huh WS, Kim DJ, et al. Urinary angiotensinogen levels reflect the severity of renal histopathology in patients with chronic kidney disease. Clin Nephrol 2011; 76: 117-23. [CrossRef]
- 22. Bargman JM, Thorpe KE, Churchill DN. CANUSA Peritoneal Dialysis Study Group. Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis: a reanalysis of the CANUSA study. J Am Soc Nephrol 2001; 12: 2158-62.
- 23. Wang AY, Wang M, Woo J, Law MC, Chow KM, Li PK, et al. A novel association between residual renal function and left ventricular hypertrophy in peritoneal dialysis patients. Kidney Int 2002; 62: 639-47. [CrossRef]
- 24. Wang AY, Wang M, Woo J, Lam CW, Lui SF, Li PK, et al. Inflammation, residual kidney function, and cardiac hypertrophy are interrelated and combine adversely to enhance mortality and cardiovascular death risk of peritoneal dialysis patients. J Am Soc Nephrol 2004; 15: 2186-94. [CrossRef]
- 25. Wang AY, Woo J, Lam CW, Wang M, Sea MM, Lui SF, et al. Is a single time point C-reactive protein predictive of outcome in peritoneal dialysis patients? J Am Soc Nephrol 2003; 14: 1871-9. [CrossRef]
- 26. Shemin D, Bostom AG, Lambert C, Hill C, Kitsen J, Kliger AS: Residual renal function in a large cohort of peritoneal dialysis patients: change over time, impact on mortality and nutrition. Perit Dial Int 2000; 20: 439-44.
- 27. Huang WH, Chen KH, Hsu CW, Chen YC, Hung CC, Huang JY, et al. Residual renal function-one of the factors associated with arterial stiffness in peritoneal dialysis patients: Insight from a retrospective study in 146 peritoneal dialysis patients. Blood Purif 2008; 26: 133-7. [CrossRef]
- 28. Nishina M. A study on angiotensin-I converting enzyme polymorphism in CAPD patients. Nippon Jinzo Gakkai Shi 1996; 38: 595- 602.
- 29. Moist LM, Port FK, Orzol SM, Young EW, Ostbye T, Wolfe RA, et al. Predictors of loss of residual renal function among new dialysis patients. J Am Soc Nephrol 2000; 11: 556-64.
- 30. Li PK, Chow KM, Wong TY, Leung CB, Szeto CC. Effects of an angiotensin-converting-enzyme inhibitor on residual renal function in patients receiving peritoneal dialysis. A randomized, controlled study. Ann Intern Med 2003; 139: 105-12. [CrossRef]
- 31. Suzuki H, Kanno Y, Suguhara S, Okada H, Nakamoto H. Effects of an angiotensin II receptor blocker, valsartan, on residual renal function in patients on CAPD. Am J Kidney Dis 2004; 43: 1056-64. [CrossRef]
- 32. Kutlugün AA, Altun B, Aktan U, Turkmen E, Altindal M, Yildirim T, et al. The relation between urinary angiotensinogen and proteinuria in renal AA amyloidosis. Amyloid 2012; 19: 28-32. [CrossRef]
- 33. Saito T, Urushihara M, Kotani Y, Kagami S, Kobori H. Increased urinary angiotensinogen is precedent to increased urinary albumin in patients with type 1 diabetes. Am J Med Sci 2009; 338: 478-80. [CrossRef]
- 34. Sawaguchi M, Araki SI, Kobori H, Urushihara M, Haneda M, Koya D, et al. Association between urinary angiotensinogen levels and renal and cardiovascular prognoses in patients with type 2 diabetes mellitus. J Diabetes Investig 2012; 3: 318-24. [CrossRef]
- 35. Jang HR, Kim SM, Lee YJ, Lee JE, Huh W, Kim DJ, et al. The origin and the clinical significance of urinary angiotensinogen in proteinuric IgA nephropathy patients. Ann Med 2012; 44: 448-57. [CrossRef]
- 36. Urushihara M, Kondo S, Kagami S, Kobori H. Urinary angiotensinogen accurately reflects intrarenal Renin-Angiotensin system activity. Am J Nephrol 2010; 31: 318-25. [CrossRef]
- 37. Lee YJ, Cho S, Kim SR, Jang HR, Lee JE, Huh W, et al. Effect of losartan on proteinuria and urinary angiotensinogen excretion in non-diabetic patients with chronic kidney disease. Postgrad Med J 2011; 87: 664-9. [CrossRef]
- 38. Jang HR, Lee YJ, Kim SR, Kim SG, Jang EH, Lee JE, et al. Potential role of urinary angiotensinogen in predicting antiproteinuric effects of angiotensin receptor blocker in non-diabetic chronic kidney disease patients: a preliminary report. Postgrad Med J 2012; 88: 210-6. [CrossRef]
- 39. Ogawa S, Kobori H, Ohashi N, Urushihara M, Nishiyama A, Mori T, et al. Angiotensin II type 1 receptor blockers reduce urinary angiotensinogen excretion and the levels of urinary markers of oxidative stress and inflammation in patients with type II diabetic nephropathy. Biomark Insights 2009; 4: 97-102. [CrossRef]
- 40. Sachetelli S, Liu Q, Zhang SL, Liu F, Hsieh TJ, Brezniceanu ML, et al. RAS blockade decreases blood pressure and proteinuria in transgenic mice overexpressing rat angiotensinogen gene in the kidney. Kidney Int 2006; 69: 1016-23. [CrossRef]
- 41. Kobori H, Prieto-Carrasquero MC, Ozawa Y, Navar LG. AT1 receptor mediated augmentation of intrarenal angiotensinogen in angiotensin-II mediated hypertension. Hypertension 2004; 43: 1126-32. [CrossRef]
- 42. Kobori H, Nishiyama A, Abe Y, Navar LG. Enhancement of intrarenal angiotensinogen in Dahl salt-sensitive rats on high salt diet. Hypertension 2003; 41: 592-7. [CrossRef]
- 43. Kobori H, Urushihara M, Xu JH, Berenson GS, Navar LG. Urinary angiotensinogen is correlated with blood pressure in men (Bogalusa Heart Study). J Hypertens 2010; 28: 1422-8. [CrossRef]
| APA | YILDIRIM T, Yilmaz R, AZAK A, ALTINDAL M, TÜRKMEN E, ARICI M, Duranay M, ERDEM Y, ALTUN B (2019). Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. , 17 - 23. 10.5152/turkjnephrol.2019.3101 |
| Chicago | YILDIRIM Tolga,Yilmaz Rahmi,AZAK Alper,ALTINDAL Mahmut,TÜRKMEN Ercan,ARICI Mustafa,Duranay Murat,ERDEM YUNUS,ALTUN BULENT ALTUN Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. (2019): 17 - 23. 10.5152/turkjnephrol.2019.3101 |
| MLA | YILDIRIM Tolga,Yilmaz Rahmi,AZAK Alper,ALTINDAL Mahmut,TÜRKMEN Ercan,ARICI Mustafa,Duranay Murat,ERDEM YUNUS,ALTUN BULENT ALTUN Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. , 2019, ss.17 - 23. 10.5152/turkjnephrol.2019.3101 |
| AMA | YILDIRIM T,Yilmaz R,AZAK A,ALTINDAL M,TÜRKMEN E,ARICI M,Duranay M,ERDEM Y,ALTUN B Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. . 2019; 17 - 23. 10.5152/turkjnephrol.2019.3101 |
| Vancouver | YILDIRIM T,Yilmaz R,AZAK A,ALTINDAL M,TÜRKMEN E,ARICI M,Duranay M,ERDEM Y,ALTUN B Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. . 2019; 17 - 23. 10.5152/turkjnephrol.2019.3101 |
| IEEE | YILDIRIM T,Yilmaz R,AZAK A,ALTINDAL M,TÜRKMEN E,ARICI M,Duranay M,ERDEM Y,ALTUN B "Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients." , ss.17 - 23, 2019. 10.5152/turkjnephrol.2019.3101 |
| ISNAD | YILDIRIM, Tolga vd. "Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients". (2019), 17-23. https://doi.org/10.5152/turkjnephrol.2019.3101 |
| APA | YILDIRIM T, Yilmaz R, AZAK A, ALTINDAL M, TÜRKMEN E, ARICI M, Duranay M, ERDEM Y, ALTUN B (2019). Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. Turkish journal of nephrology (Online), 28(1), 17 - 23. 10.5152/turkjnephrol.2019.3101 |
| Chicago | YILDIRIM Tolga,Yilmaz Rahmi,AZAK Alper,ALTINDAL Mahmut,TÜRKMEN Ercan,ARICI Mustafa,Duranay Murat,ERDEM YUNUS,ALTUN BULENT ALTUN Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. Turkish journal of nephrology (Online) 28, no.1 (2019): 17 - 23. 10.5152/turkjnephrol.2019.3101 |
| MLA | YILDIRIM Tolga,Yilmaz Rahmi,AZAK Alper,ALTINDAL Mahmut,TÜRKMEN Ercan,ARICI Mustafa,Duranay Murat,ERDEM YUNUS,ALTUN BULENT ALTUN Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. Turkish journal of nephrology (Online), vol.28, no.1, 2019, ss.17 - 23. 10.5152/turkjnephrol.2019.3101 |
| AMA | YILDIRIM T,Yilmaz R,AZAK A,ALTINDAL M,TÜRKMEN E,ARICI M,Duranay M,ERDEM Y,ALTUN B Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. Turkish journal of nephrology (Online). 2019; 28(1): 17 - 23. 10.5152/turkjnephrol.2019.3101 |
| Vancouver | YILDIRIM T,Yilmaz R,AZAK A,ALTINDAL M,TÜRKMEN E,ARICI M,Duranay M,ERDEM Y,ALTUN B Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients. Turkish journal of nephrology (Online). 2019; 28(1): 17 - 23. 10.5152/turkjnephrol.2019.3101 |
| IEEE | YILDIRIM T,Yilmaz R,AZAK A,ALTINDAL M,TÜRKMEN E,ARICI M,Duranay M,ERDEM Y,ALTUN B "Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients." Turkish journal of nephrology (Online), 28, ss.17 - 23, 2019. 10.5152/turkjnephrol.2019.3101 |
| ISNAD | YILDIRIM, Tolga vd. "Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients". Turkish journal of nephrology (Online) 28/1 (2019), 17-23. https://doi.org/10.5152/turkjnephrol.2019.3101 |
