Changes in urinary angiotensinogen posttreatment in pediatric IgA nephropathy patients.

Abstract

BACKGROUND:

Recently, we demonstrated that urinary angiotensinogen (AGT) levels are increased and reflect intrarenal renin-angiotensin system (RAS) status in pediatric patients with chronic glomerulonephritis. Therefore, this study was performed to test the hypothesis that urinary AGT (UAGT) levels provide a specific index of intrarenal RAS status associated with RAS blockade treatment in pediatric IgA nephropathy (IgAN) patients.

METHODS:

We measured plasma and UAGT levels and urinary transforming growth factor beta (TGF-β) levels, after which we performed immunohistochemical analysis of AGT, angiotensin II (Ang II), and TGF-β in 24 pediatric IgAN patients treated with RAS blockades for 2 years. Paired tests were used to analyze the changes from baseline to study end.

RESULTS:

Although there was no change in plasma AGT levels, UAGT and TGF-β levels were significantly decreased after RAS blockade, which was accompanied by the expression levels of AGT, Ang II, and TGF-β, as well as the magnitude of glomerular injury. Baseline UAGT levels positively correlated with diastolic blood pressure, urinary protein levels, scores for mesangial hypercellularity, and the expression levels of AGT, Ang II, and TGF-β in renal tissues.

CONCLUSIONS:

These data indicate that UAGT is a useful biomarker of intrarenal RAS activation, which is associated with glomerular injury during RAS blockade in pediatric IgAN patients.

• Authors: Maki Urushihara, Takashi Nagai, Yukiko Kinoshita, Sato Nishiyama, Kenichi Suga, Natsuko Ozaki, Ariunbold Jamba, Shuji Kondo, Hiroyuki Kobori, Shoji Kagami
• Journal: Pediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 30 Issue 6 Pg. 975-82 (Jun 2015) ISSN: 1432-198X [Electronic] Germany
• PMID: 25523477 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• AGT protein, human
• Angiotensin II Type 1 Receptor Blockers
• Angiotensin-Converting Enzyme Inhibitors
• Biomarkers
• Transforming Growth Factor beta
• Angiotensinogen
• Angiotensin II

Topics

• Adolescent
• Angiotensin II (blood, urine)
• Angiotensin II Type 1 Receptor Blockers (therapeutic use)
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Angiotensinogen (blood, urine)
• Biomarkers (blood, urine)
• Biopsy
• Child
• Enzyme-Linked Immunosorbent Assay
• Female
• Glomerulonephritis, IGA (diagnosis, drug therapy, physiopathology, urine)
• Humans
• Immunohistochemistry
• Kidney (drug effects, metabolism, pathology, physiopathology)
• Male
• Predictive Value of Tests
• Renin-Angiotensin System (drug effects)
• Time Factors
• Transforming Growth Factor beta (blood, urine)
• Treatment Outcome
• Urinalysis