title: Changes in Urinary Angiotensinogen Associated with Deterioration of Kidney Function in Patients with Type 2 Diabetes Mellitus.
abstract: Urinary angiotensinogen (AGT) is potentially a specific biomarker for the status of the intrarenal renin-angiotensin system (RAS) in patients with diabetes mellitus. We explored whether changes in urinary AGT excretion levels were associated with the deterioration of kidney function in type 2 diabetes patients with preserved kidney function. Urinary baseline AGT levels were measured in 118 type 2 diabetic patients who were not taking RAS blockers and who had estimated glomerular filtration rates (eGFRs) ≥ 60 mL/min/1.73 m². A total of 91 patients were followed-up for 52 months. Changes in urinary levels of AGT (ΔAGT) were calculated by subtracting urinary AGT/creatinine (Cr) at baseline from urinary AGT/Cr after 1 year. ΔAGT was significantly inversely correlated with annual eGFR change (β = -0.29, P = 0.006; β = -0.37, P = 0.001 after adjusting for clinical factors). RAS blockers were prescribed in 36.3% of patients (n = 33) during follow-up. The ΔAGT values were lower in the RAS blockers users than in the non-RAS blockers users, but the differences were not statistically significant (7.37 ± 75.88 vs. 22.55 ± 57.45 μg/g Cr, P = 0.081). The ΔAGT values remained significantly correlated with the annual rate of eGFR change (β = -0.41, P = 0.001) in the patients who did not use RAS blockers, but no such correlation was evident in the patients who did. ΔAGT is inversely correlated with annual changes in eGFR in type 2 diabetes patients with preserved kidney function, particularly in RAS blocker-naïve patients.
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Min Jin
authors.identifier: http://orcid.org/0000-0002-4351-789X
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Sang Soo
authors.identifier: http://orcid.org/0000-0002-9687-8357
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. injkim@pusan.ac.kr.
authors.forename: In Joo
authors.identifier: http://orcid.org/0000-0003-1307-6146
authors.initials: IJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Sang Heon
authors.identifier: http://orcid.org/0000-0002-8218-6974
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Eun Heui
authors.identifier: http://orcid.org/0000-0001-9000-4870
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Ji Yeong
authors.identifier: http://orcid.org/0000-0002-6056-5578
authors.initials: JY
authors.lastname: Seo
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Jong Ho
authors.identifier: http://orcid.org/0000-0001-9781-1376
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Sungsu
authors.identifier: http://orcid.org/0000-0002-8858-1932
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Yun Kyung
authors.identifier: http://orcid.org/0000-0002-4319-5181
authors.initials: YK
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Bo Hyun
authors.identifier: http://orcid.org/0000-0001-9632-9457
authors.initials: BH
authors.lastname: Kim
authors.affiliation: Kim Yong Ki Internal Medicine Clinic, Busan, Korea.
authors.forename: Yong Ki
authors.identifier: http://orcid.org/0000-0001-9321-1736
authors.initials: YK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000473:pathology; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D000808:Angiotensinogen / Q000652:urine*; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects
chemical_list: D057911:Angiotensin Receptor Antagonists; D000808:Angiotensinogen; D003404:Creatinine
keywords: Angiotensinogen; Diabetic Kidney Disease; Renin-Angiotensin System; Type 2 Diabetes Mellitus