Association of urinary angiotensinogen with renal arteriolar remodeling in chronic kidney disease
Association of urinary angiotensinogen with renal arteriolar remodeling in chronic kidney disease
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DOI：
10.1097/hjh.0000000000003031
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发表时间：
2022-04-01
影响因子：
4.9
通讯作者：
Ohya，Yusuke
中科院分区：
文献类型：
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作者：
Kanamitsu，Takafumi;Kohagura，Kentaro;Ohya，Yusuke
目的：肾素-血管紧张素系统（RAS）可能与小动脉重构有关。本研究旨在探讨迄今未知的肾RAS和肾小动脉重塑之间的关系，并阐明是否改变肾RAS随后影响肾功能的慢性肾脏病（CKD）患者。方法：在这项回顾性研究中，各种CKD患者不使用RAS抑制剂谁接受肾活检被列入横断面和纵向分析。测定尿血管紧张素原（UAGT）水平和管壁/管腔比（WLR），分别评价肾RAS和肾小动脉重构。使用线性回归模型对ln（UAGT）和ln（WLR）之间的相关性进行了横断面检查。此外，与随后的变化，估计肾小球滤过率（eGFR）每年的关联进行了纵向检查，在最大的亚组的患者谁被诊断为伊加nephropathy.Results：在整个队列（n= 54），中位年龄，血压，eGFR，和WLR分别为37岁，120/73毫米汞柱，85毫升/分钟每1.73平方米，和0.93，分别。即使在校正经典和非经典临床肾脏危险因素后，Ln（UAGT）与ln（WLR）仍显著正相关。在伊加肾病患者中，较高的ln（UAGT）与较高的ln（WLR）相关。Ln（UAGT）也往往与更大的下降，eGFR每年超过一个中位数为8.7年，即使调整后的潜在的混杂factors.Conclusion：在CKD患者，肾RAS可能与肾小动脉重塑和未来下降的eGFR，独立的潜在危险因素。
Objective:Renin–angiotensin system (RAS) might be associated with arteriolar remodeling. The present study aimed to explore the hitherto unknown relationship between renal RAS and renal arteriolar remodeling and to elucidate whether altered renal RAS subsequently affects renal function in patients with chronic kidney disease (CKD).Methods:In this retrospective study, patients with various CKDs not using RAS inhibitors who underwent renal biopsy were included in cross-sectional and longitudinal analyses. Urinary angiotensinogen (UAGT) levels and wall/lumen ratio (WLR) were determined to evaluate renal RAS and renal arteriolar remodeling, respectively. The association between ln (UAGT) and ln (WLR) was cross-sectionally examined using a liner regression model. Furthermore, the association of ln (UAGT) with subsequent changes in estimated glomerular filtration rate (eGFR) per year were longitudinally examined in the largest subgroup of patients who were diagnosed with IgA nephropathy.Results:In the overall cohort (n= 54), the median age, blood pressures, eGFR, and WLR were 37 years, 120/73 mmHg, 85 ml/min per 1.73 m 2, and 0.93, respectively. Ln (UAGT) was significantly and positively associated with ln (WLR) even after adjusting for classical and nonclassical clinical renal risk factors. In patients with IgA nephropathy, higher ln (UAGT) was associated with higher ln (WLR). Ln (UAGT) also tended to be associated with a greater decline in eGFR per year over a median period of 8.7 years, even after adjusting for potential confounding factors.Conclusion:In patients with CKD, renal RAS might be associated with renal arteriolar remodeling and future decline in eGFR, independent of potential risk factors.