Elevated urinary angiotensinogen excretion links central and renal hemodynamic alterations

Inappropriate activation of intrarenal renin–angiotensin system (RAS) may contribute to the pathogenesis of cardio-renal syndrome (CRS). We aimed to examine the cross-sectional associations of urinary angiotensinogen (AGT) excretion, a biomarker of intrarenal RAS activity, with central (aortic) and...

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Published in:Scientific reports 2023-07, Vol.13 (1), p.11518-11518, Article 11518
Main Authors: Kosaki, Keisei, Park, Jiyeon, Matsui, Masahiro, Sugaya, Takeshi, Kuro-o, Makoto, Saito, Chie, Yamagata, Kunihiro, Maeda, Seiji
Format: Article
Language:English
Subjects:
692/4022/272/1684
692/53/2423
Angiotensin
Angiotensinogen
Aorta
Blood flow
Body mass index
Brain natriuretic peptide
Excretion
Fatty acid-binding protein
Glomerular filtration rate
Hemodynamics
Humanities and Social Sciences
Kidney diseases
Middle age
multidisciplinary
Older people
Renal function
Renin
Science
Science (multidisciplinary)
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Summary:Inappropriate activation of intrarenal renin–angiotensin system (RAS) may contribute to the pathogenesis of cardio-renal syndrome (CRS). We aimed to examine the cross-sectional associations of urinary angiotensinogen (AGT) excretion, a biomarker of intrarenal RAS activity, with central (aortic) and renal hemodynamic parameters in middle-aged and older adults, including patients with chronic kidney disease. Aortic and renal hemodynamic parameters were measured using applanation tonometry and duplex ultrasonography in 282 participants. Urinary AGT, liver-type fatty acid-binding protein (L-FABP), and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured for each participant. Multiple linear regression analyses demonstrated that urinary AGT levels were associated with aortic blood pressures, pulsatile measures of renal blood flow, plasma NT-proBNP and urinary L-FABP levels after adjusting for potential covariates, including age, sex, body mass index, estimated glomerular filtration rate (GFR), and medication use. Additionally, when classified based on GFR stages and urinary AGT levels, plasma NT-proBNP and urinary L-FABP levels increased in participants with lower GFR and higher AGT groups. Our findings suggest that urinary AGT excretion is a shared determinant of central (aortic) and renal hemodynamics in middle-aged and older adults, providing clinical evidence for the potential role of intrarenal RAS activity in the development of CRS.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-023-38507-w