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KMID : 0359920080270020186
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Korean Journal of Nephrology
2008 Volume.27 No. 2 p.186 ~ p.194
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Effects of Losartan on the Urinary Angiotensinogen Excretion in Chronic Non-diabetic Proteinuric Renal Disease
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Do Yeun-Sil
Choi So-Yeon
Jang Eun-Hee
Kim Yong-Kyun
Baek Hyun-Jeong
Lee Jung-Eun
Huh Woo-Sung
Kim Dae-Joong
Oh Ha-Young
Kim Yoon-Goo
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Abstract
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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 L/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.
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KEYWORD
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Renin-angiotensin system, Proteinuria, Angiotensinogen
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