Relationship between urinary angiotensinogen and salt sensitivity of blood pressure in patients with IgA nephropathy

Yoshio Konishi, Akira Nishiyama, Takashi Morikawa, Chizuko Kitabayashi, Mikiko Shibata, Masahiro Hamada, Masatsugu Kishida, Hirofumi Hitomi, Hideyasu Kiyomoto, Takenori Miyashita, Nozomu Mori, Maki Urushihara, Hiroyuki Kobori, Masahito Imanishi

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)

Abstract

We demonstrated previously that the blood pressure of patients with IgA nephropathy becomes salt sensitive as renal damage progresses. We also showed that increased urinary angiotensinogen levels in such patients closely correlate with augmented renal tissue angiotensinogen gene expression and angiotensin II levels. Here, we investigated the relationship between urinary angiotensinogen and salt sensitivity of blood pressure in patients with IgA nephropathy. Forty-one patients with IgA nephropathy consumed an ordinary salt diet (12 g/d of NaCl) for 1 week and a low-salt diet (5 g/d of NaCl) for 1 week in random order. The salt-sensitivity index was calculated as the reciprocal of the slope of the pressure-natriuresis curve drawn by linking 2 data points obtained during consumption of each diet. The urinary angiotensinogen:creatinine ratio was significantly higher in patients who consumed the ordinary salt diet compared with the low-salt diet (17.5 μg/g [range: 7.3 to 35.6 μg/g] versus 7.9 μg/g [range: 3.1 to 14.2 μg/g] of creatinine, respectively; P<0.001). The sodium sensitivity index in our patients positively correlated with the glomerulosclerosis score (r=0.43; P=0.008) and changes in logarithmic urinary angiotensinogen:creatinine ratio (r=0.37; P=0.017) but not with changes in urinary protein excretion (r=0.18; P=0.49). In contrast, changes in sodium intake did not alter the urinary angiotensinogen:creatinine ratio in patients with Ménière disease and normal renal function (n=9). These data suggest that the inappropriate augmentation of intrarenal angiotensinogen induced by salt and associated renal damage contribute to the development of salt-sensitive hypertension in patients with IgA nephropathy.

Original languageEnglish
Pages (from-to)205-211
Number of pages7
JournalHypertension
Volume58
Issue number2
DOIs
Publication statusPublished - 2011 Aug

Keywords

  • Angiotensinogen
  • IgA nephropathy
  • glomerulonephritis
  • hypertension
  • renin-angiotensin system
  • salt

ASJC Scopus subject areas

  • Internal Medicine

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