Potential role of urinary angiotensinogen in predicting antiproteinuric effects of angiotensin receptor blocker in non-diabetic chronic kidney disease patients: a preliminary report

Postgraduate Medical Journal, 04/26/2012

The antiproteinuric effects of angiotensin receptor blocker (ARB) were different according to the initial urinary angiotensinogen levels. These results suggest the potential value of the initial urinary angiotensinogen/creatinine ratio (AGT/Cr) for predicting the therapeutic effect of ARB in proteinuric non–diabetic chronic kidney disease (CKD) patients.

Methods

  • Between September 2005 and September 2008, in 50 non–diabetic proteinuric CKD patients not taking renin–angiotensin system inhibitors, the urinary protein/creatinine ratio (P/Cr), angiotensinogen/creatinine ratio (AGT/Cr), plasma renin and aldosterone were measured before starting valsartan, and were followed for 18 months.
  • Patients were divided into three groups according to their initial urinary AGT/Cr.

Results

  • The urinary P/Cr was lower in the low angiotensinogen group, but similar in the high and extremely high angiotensinogen groups (1.3±0.38 vs 2.0±0.92 vs 2.2±0.78).
  • In all groups, the urinary P/Cr was decreased most for the first 6 months.
  • The urinary P/Cr reduction at 6 months was greatest in the high angiotensinogen group (–24.2% vs –46.2% vs –16.4%).
  • The urinary AGT/Cr was decreased most in the high angiotensinogen group.
  • Renal functional deterioration was attenuated in the high angiotensinogen group compared with the extremely high angiotensinogen group.

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