Effects of Losartan on the Urinary Angiotensinogen Excretion
in Chronic Non-diabetic Proteinuric Renal Disease

Korean Journal of Nephrology 2008;27(2):186-194.

Effects of Losartan on the Urinary Angiotensinogen Excretion in Chronic Non-diabetic Proteinuric Renal Disease

Yeon Sil Do, M.D.1, So Yeon Choi, M.D.2, Eun Hee Jang, M.D.3, Yong Kyun Kim, M.D.4,Hyunjeong Baek, M.D.5, Jung Eun Lee, M.D.1, Wooseong Huh, M.D.1, Dae Jung Kim, M.D.1,Ha Young Oh, M.D.1 and Yoon-Goo Kim, M.D.1

Department of Medicine¹
Samsung Medical Center, Sungkyunkwan University Eulji University Hospital²
Jeju University Hospital3 Kangwon National University School of Medicine5

원저 : 만성 비당뇨성 신장병증에서 Losartan이 단백뇨와 요중 안지오텐시노겐 배설량에 미치는 효과

도연실1·최소연2·장은희3·김용균4·백현정5·이정은1·허우성1·김대중1·오하영1·김윤구1

성균관대학교 의과대학 삼성서울병원 내과1, 을지의과대학교 내과2, 제주의과대학교 내과3,가톨릭의과대학교 내과4, 강원대학교 의과대학 내과학교실5

Abstract

Purpose
: There were experimental evidences supporting that intrarenal activation of the renin-angiotensin system contributes to increase BP, proteinuria and urinary angiotensinogen (UAGT) excretion. The purpose of this prospective, open label, controlled study was to investigate the effect of losartan on proteinuria and UAGT excretion in chronic non-diabetic proteinuric (0.4 to 2.0 g/day) renal disease with normal renal function (glomerular filtration rate, GFR>60 mL/min/1.73m2).
Methods
: Thirty two patients were randomly allocated to the losartan group (100 mg/day; n=17) or the control group (n=15). Systolic BP, diastolic BP, estimated GFR, urinary protein to creatinine ratio (UP/Cr), UAGT and plasma angiotensinogen (PAGT) level were compared between two groups at baseline, 6 months and 12 months.
Results
: UP/Cr (1.13±0.36 g/g vs. 1.07±0.34 g/g) was similar in two groups at baseline. Target BP (<140/90 mmHg) was maintained in both groups. After 6 months, UP/Cr (0.63±0.35 g/g vs. 0.97± 0.41 g/g, p<0.01) was significantly decreased in the losartan group compared to the control group. In addition, UAGT (baseline 1.0) was noticeably suppressed in the losartan group (0.72±0.42 vs. 1.07 ±0.81, p=0.13). However, PAGT was not changed in both groups. Moreover, our study at 12 months period has demonstrated continuous suppression of UP/Cr (0.79±0.53 g/g vs. 1.00±0.50 g/g, p=0.06) and UAGT (0.60±0.51 vs. 1.51±1.36, p<0.05) in the losartan group. UP/Cr was highly correlated with UAGT (Correlation Coefficient=0.74, p<0.01), but not with PAGT.
Conclusion
: Losartan not only induced a remarkable decrease in proteinuria but also contributed a reduction in UAGT in patients with chronic non-diabetic proteinuric renal disease.

Key Words: Renin-angiotensin system, Proteinuria, Angiotensinogen