Korean Journal of Nephrology 2011;30(5):506-515.
The Usefulness of Urinary Angiotensinogen as a Biomarker of Renal Progression in Autosomal Dominant Polycystic Kidney Disease
Hayne Cho Park, M.D.1, 3, Jin Ho Hwang, M.D.1, Seon ha Baek, M.D.1, Mi Yeun Han, M.D.1, Yu Kyoung Yun, B.S.2, Myeong-Ok Yoon, B.S.3, Kook-Hwan Oh, M.D.1, Ja Ryong Koo, M.D.4, Hyung Jik Kim, M.D.4, Jung Woo Noh, M.D.4, Kyu Beck Lee, M.D.5, Woo Kyung Chung,
Department of Internal Medicine1
Seoul National University College of Medicine, Department of Internal Medicine2
Eulji General Hospital, Transplant Research Institute3
Seoul National University Hospital, Department of Internal Medicine4
Hallym University College of Medicine, Department of Internal Medicine5
Sungkyunkwan University College of Medicine, Department of Internal Medicine, Gachon University of Medicine and Science6
Department of Internal Medicine, The Catholic University of Korea College of Medicine7
원저 : 상염색체우성 다낭신에서 질병진행 예측인자로서 요중 안지오텐시노겐의 유용성
박혜인조1, 3, 황진호1, 백선하1, 한미연1, 윤유경2, 윤명옥3, 오국환1, 구자룡4, 김형직4, 노정우4, 이규백5, 정우경6, 김영옥7, 안규리1, 3, 황영환2
서울대학교 의과대학 내과학교실1 , 을지병원 신장내과2 , 서울대학교 병원 장기이식연구소3, 한림대학교 의과대학 내과학교실4 , 성균관대학교 의과대학 내과학교실5, 가천의과대학교 내과학교실6 , 가톨릭대학교 의과대학 내과학교실7
Abstract
Purpose: The renin-angiotensin-aldosterone system activation has been suggested as a potential risk factor for renal progression in autosomal dominant polycystic kidney disease (ADPKD). This study was performed to evaluate urinary angiotensinogen as a biomarker of renal progression in ADPKD. Methods: Patients with estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73m2 were enrolled in the study. Specimens (blood and urine) and computed tomography (CT) were taken from each subject. The eGFR was calculated by 4-variable MDRD equation and total kidney volume (TKV) was measured from CT images by modified ellipsoid method. Urinary angiotensinogen (AGT) and neutrophil gelatinaseassociated lipocalin (NGAL) were measured by ELISA. The concentration of AGT was adjusted with random urine creatinine (Cr). The association between urinary biomarkers, TKV and eGFR were evaluated. Results: A total of 59 (M:F=31:28) subjects were enrolled in the study and their mean age was 46 years. The eGFR and TKV at the enrollment were 77.3±15.6 mL/min/1.73m2 and 1389.8±925.1 mL, respectively. Log AGT/Cr was associated with TKV (r2=0.117, p=0.01) in the earlier stage of disease (TKV<3,000 mL). However, it did not show significant correlation with eGFR. Log NGAL was not associated with either TKV or eGFR. Urinary AGT/Cr was closely related to the number of anti-hypertensive medication, TKV, and the presence of albuminuria, although there was no correlation with plasma renin activity or aldosterone level. Conclusion: Urinary angiotensinogen may be a useful biomarker of disease progression in ADPKD patients.
Key Words: Polycystic Kidney Diseases, Biomarkers, Angiotensinogen, Disease Progression, Organ Size


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