title: A link between the intrarenal renin angiotensin system and hypertension in autosomal dominant polycystic kidney disease.
abstract: OBJECTIVE
  Early onset of hypertension and its consequences account for the great majority of deaths in patients with autosomal dominant polycystic kidney disease (ADPKD). Renin-angiotensin system (RAS) components have been shown in ADPKD kidneys independent of systemic RAS. Thus, we examined the urinary angiotensinogen (UAGT) levels as a biomarker of intrarenal RAS status in ADPKD patients with/without hypertension and healthy subjects.
  
  
  METHODS
  Eighty-four ADPKD patients (43 with hypertension and 41 without hypertension) and 40 healthy controls were studied cross-sectionally. Patients with glomerular filtration rate <60 ml/min were excluded from the study. Hypertension was diagnosed with ambulatory blood pressure monitoring. Urinary and plasma concentration of angiotensinogen, spot urine microprotein and creatinine (UCre) levels were recorded for each participant.
  
  
  RESULTS
  UAGT/UCre levels were higher in hypertensive ADPKD patients (23.7 ± 8.4) compared with normotensive ADPKD patients (16.6 ± 5.2) and healthy controls (6.9 ± 3.3; p < 0.001). In univariate analysis, UAGT correlated with systolic blood pressure, diastolic blood pressure (DBP) and proteinuria. The independence of these correlations was analyzed in a regression model, and UAGT was shown to be significantly predicted by proteinuria and DBP.
  
  
  CONCLUSIONS
  Intrarenal RAS activation which is monitored by UAGT levels clinically may be a harbinger of hypertension and kidney disease in ADPKD patients.
authors.affiliation: Department of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey. iikocyigit@gmail.com
authors.forename: Ismail
authors.initials: I
authors.lastname: Kocyigit
authors.forename: Mahmut Ilker
authors.initials: MI
authors.lastname: Yilmaz
authors.forename: Aydin
authors.initials: A
authors.lastname: Unal
authors.forename: Fahir
authors.initials: F
authors.lastname: Ozturk
authors.forename: Eray
authors.initials: E
authors.lastname: Eroglu
authors.forename: Cevat
authors.initials: C
authors.lastname: Yazici
authors.forename: Ozcan
authors.initials: O
authors.lastname: Orscelik
authors.forename: Murat Hayri
authors.initials: MH
authors.lastname: Sipahioglu
authors.forename: Bulent
authors.initials: B
authors.lastname: Tokgoz
authors.forename: Oktay
authors.initials: O
authors.lastname: Oymak
mesh_terms: D000328:Adult; D000808:Angiotensinogen / Q000097:blood / Q000652:urine; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D016022:Case-Control Studies; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000473:pathology; D011507:Proteinuria / Q000378:metabolism; D012044:Regression Analysis; D012084:Renin-Angiotensin System / Q000502:physiology*
chemical_list: D000808:Angiotensinogen; D003404:Creatinine