title: 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?
abstract: The aim of this study was to evaluate the relationship of local intrarenal renin angiotensin system (RAS) with hypertension and proteinuria in renal transplant recipients. Sixty-nine nondiabetic renal transplant recipients (39 male, mean age: 36.3 ± 11.5 years) were included in this study. All patients were in stable condition with GFR greater than 30 ml/min/1.73 m(2); (MDRD). Hypertension was defined to be present if there was a recorded diagnosis of hypertension, systolic blood pressure >130 mmHg and/or diastolic blood pressure >80 mmHg according to ambulatory blood pressure monitoring. None of the hypertensive patients were receiving RAS blockers. Spot urine samples were obtained to measure urinary angiotensinogen (AGT) using human AGT-ELISA, urinary creatinine and protein levels. The demographic properties and laboratory findings were similar between hypertensive and normotensive transplant recipients. Urinary AGT-creatinine ratio (UAGT/UCre) was significantly higher in hypertensive patients compared with the normotensives (8.98 ± 6.89 μg/g vs. 5.48 ± 3.33 μg/g; P = 0.037). Importantly, a significantly positive correlation was found between UAGT/Ucre levels and proteinuria in hypertensive patients (P = 0.01, r = 0.405). Local intrarenal RAS probably plays an important role in the development of hypertension and proteinuria in renal transplant recipients.
authors.affiliation: Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. draysunaybal@yahoo.com
authors.forename: Aysun
authors.initials: A
authors.lastname: Aybal Kutlugun
authors.forename: Bulent
authors.initials: B
authors.lastname: Altun
authors.forename: Yahya
authors.initials: Y
authors.lastname: Buyukasik
authors.forename: Tuncay
authors.initials: T
authors.lastname: Aki
authors.forename: Ercan
authors.initials: E
authors.lastname: Turkmen
authors.forename: Mahmut
authors.initials: M
authors.lastname: Altindal
authors.forename: Tolga
authors.initials: T
authors.lastname: Yildirim
authors.forename: Rahmi
authors.initials: R
authors.lastname: Yilmaz
authors.forename: Cetin
authors.initials: C
authors.lastname: Turgan
mesh_terms: D000328:Adult; D000808:Angiotensinogen / Q000652:urine*; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D003404:Creatinine / Q000652:urine; D003971:Diastole; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006977:Hypertension, Renal / Q000097:blood*; D007668:Kidney / Q000378:metabolism*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000378:metabolism*; D051437:Renal Insufficiency / Q000628:therapy; D013599:Systole
chemical_list: D000808:Angiotensinogen; D003404:Creatinine