title: Overexpression of Intrarenal Renin-Angiotensin System in Human Acute Tubular Necrosis.
abstract: OBJECTIVE
  Acute tubular necrosis (ATN), a leading cause of acute kidney injury (AKI), is associated with decreased survival and increased progression of chronic kidney disease. A barrier to improving the clinical outcomes is the incomplete understanding of the pathogenesis of AKI. Our objective is to test the hypothesis that intrarenal renin-angiotensin system (RAS) is overexpressed in patients with ATN and could be an indicator of ATN severity.
  
  
  METHODS
  A transversal study was conducted in patients with biopsy-proven ATN. Intrarenal expression of angiotensinogen and angiotensin II, and urinary angiotensinogen were measured.
  
  
  RESULTS
  Patients with ATN demonstrated upregulation of intrarenal RAS, evidenced by upregulation of intrarenal angiotensinogen and angiotensin II. Patients with ATN also have elevated urinary angiotensinogen level that correlated with the overexpressed intrarenal RAS. Moreover, this increase in intrarenal RAS expression and urinary angiotensinogen was associated with the extent of acute tubular injury and urinary albumin excretion, respectively.
  
  
  CONCLUSIONS
  We demonstrate that the intrarenal RAS is upregulated in patients with ATN and is associated with the severity of ATN. Urinary angiotensinogen reflects intrarenal RAS status, and is of value to assess the severity of ATN.
authors: Division of Nephrology, Nanfang Hospital, Guangzhou, P.R. China.
authors: Wei
authors: W
authors: Cao
authors: Lingwei
authors: L
authors: Jin
authors: Zhanmei
authors: Z
authors: Zhou
authors: Manqiu
authors: M
authors: Yang
authors: Chunyi
authors: C
authors: Wu
authors: Liling
authors: L
authors: Wu
authors: Shuang
authors: S
authors: Cui
mesh_terms: D000328:Adult; D000418:Albumins / Q000032:analysis; D000804:Angiotensin II / Q000652:urine; D000808:Angiotensinogen / Q000652:urine; D005260:Female; D006801:Humans; D007683:Kidney Tubular Necrosis, Acute / Q000378:metabolism* / Q000473:pathology / Q000652:urine; D007684:Kidney Tubules / Q000293:injuries; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000235:genetics*; D012720:Severity of Illness Index; D015854:Up-Regulation
chemical_list: D000418:Albumins; D000808:Angiotensinogen; D000804:Angiotensin II