Changes in Urinary Angiotensinogen Associated with Deterioration of Kidney Function in Patients with Type 2 Diabetes Mellitus.
10.3346/jkms.2017.32.5.782
- Author:
Min Jin LEE
1
;
Sang Soo KIM
;
In Joo KIM
;
Sang Heon SONG
;
Eun Heui KIM
;
Ji Yeong SEO
;
Jong Ho KIM
;
Sungsu KIM
;
Yun Kyung JEON
;
Bo Hyun KIM
;
Yong Ki KIM
Author Information
1. Department of Internal Medicine, Pusan National University Hospital, Busan, Korea. injkim@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Angiotensinogen;
Diabetic Kidney Disease;
Type 2 Diabetes Mellitus;
Renin-Angiotensin System
- MeSH:
Angiotensinogen*;
Diabetes Mellitus;
Diabetes Mellitus, Type 2*;
Diabetic Nephropathies;
Follow-Up Studies;
Glomerular Filtration Rate;
Humans;
Kidney*;
Renin-Angiotensin System
- From:Journal of Korean Medical Science
2017;32(5):782-788
- CountryRepublic of Korea
- Language:English
-
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.
