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Visniauskas B, Reverte V, Abshire CM, Ogola BO, Rosales CB, Galeas-Pena M, Sure VN, Sakamuri SSVP, Harris NR, Kilanowski-Doroh I, Mcnally AB, Horton AC, Zimmerman M, Katakam PVG, Lindsey SH, Prieto MC. High-plasma soluble prorenin receptor is associated with vascular damage in male, but not female, mice fed a high-fat diet. Am J Physiol Heart Circ Physiol 2023; 324:H762-H775. [PMID: 36930656 PMCID: PMC10151046 DOI: 10.1152/ajpheart.00638.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Plasma soluble prorenin receptor (sPRR) displays sexual dimorphism and is higher in women with type 2 diabetes mellitus (T2DM). However, the contribution of plasma sPRR to the development of vascular complications in T2DM remains unclear. We investigated if plasma sPRR contributes to sex differences in the activation of the systemic renin-angiotensin-aldosterone system (RAAS) and vascular damage in a model of high-fat diet (HFD)-induced T2DM. Male and female C57BL/6J mice were fed either a normal fat diet (NFD) or an HFD for 28 wk to assess changes in blood pressure, cardiometabolic phenotype, plasma prorenin/renin, sPRR, and ANG II. After completing dietary protocols, tissues were collected from males to assess vascular reactivity and aortic reactive oxygen species (ROS). A cohort of male mice was used to determine the direct contribution of increased systemic sPRR by infusion. To investigate the role of ovarian hormones, ovariectomy (OVX) was performed at 32 wk in females fed either an NFD or HFD. Significant sex differences were found after 28 wk of HFD, where only males developed T2DM and increased plasma prorenin/renin, sPRR, and ANG II. T2DM in males was accompanied by nondipping hypertension, carotid artery stiffening, and aortic ROS. sPRR infusion in males induced vascular thickening instead of material stiffening caused by HFD-induced T2DM. While intact females were less prone to T2DM, OVX increased plasma prorenin/renin, sPRR, and systolic blood pressure. These data suggest that sPRR is a novel indicator of systemic RAAS activation and reflects the onset of vascular complications during T2DM regulated by sex.NEW & NOTEWORTHY High-fat diet (HFD) for 28 wk leads to type 2 diabetes mellitus (T2DM) phenotype, concomitant with increased plasma soluble prorenin receptor (sPRR), nondipping blood pressure, and vascular stiffness in male mice. HFD-fed female mice exhibiting a preserved cardiometabolic phenotype until ovariectomy revealed increased plasma sPRR and blood pressure. Plasma sPRR may indicate the status of systemic renin-angiotensin-aldosterone system (RAAS) activation and the onset of vascular complications during T2DM in a sex-dependent manner.
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Affiliation(s)
- Bruna Visniauskas
- Department of Physiology, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Tulane Center for Sex-Based Biology and Medicine, New Orleans, Louisiana, United States
| | - Virginia Reverte
- Department of Physiology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Caleb M Abshire
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Benard O Ogola
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, Georgia, United States
| | - Carla B Rosales
- Department of Physiology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Michelle Galeas-Pena
- Department of Physiology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Venkata N Sure
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Siva S V P Sakamuri
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Nicholas R Harris
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Isabella Kilanowski-Doroh
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Alexandra B Mcnally
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Alec C Horton
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Margaret Zimmerman
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Prasad V G Katakam
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Sarah H Lindsey
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Tulane Center for Sex-Based Biology and Medicine, New Orleans, Louisiana, United States
- Tulane Hypertension and Renal Center of Excellence, New Orleans, Louisiana, United States
| | - Minolfa C Prieto
- Department of Physiology, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Tulane Center for Sex-Based Biology and Medicine, New Orleans, Louisiana, United States
- Tulane Hypertension and Renal Center of Excellence, New Orleans, Louisiana, United States
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Kuai Y, Huang H, Dai X, Zhang Z, Bai Z, Chen J, Fang F, Pan J, Li X, Wang J, Li Y. In PICU acute kidney injury stage 3 or mortality is associated with early excretion of urinary renin. Pediatr Res 2022; 91:1149-1155. [PMID: 34083760 DOI: 10.1038/s41390-021-01592-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Urinary renin is proposed to be a novel prognostic biomarker of acute kidney injury (AKI) in adults. The intention of our study was to evaluate the early predictive value of urinary renin for AKI and pediatric intensive care unit (PICU) mortality in critically ill children. METHODS The first available urine sample during the first 24 h after admission was collected upon PICU admission for the measurement of renin using ELISA. Urinary renin concentrations were corrected for urinary creatinine (urinary renin-to-creatinine ratio, uRenCR). AKI was defined based on KDIGO criteria. RESULTS Of the 207 children, 22 developed AKI, including 6 with stage 1, 6 with stage 2, and 10 with stage 3, and 14 died during PICU stay. There was a significant difference in uRenCR between non-AKI children and those with AKI stage 3 (P = 0.001), but not with AKI stage 1 or 2. The uRenCR remained associated with AKI stage 3 and PICU mortality after adjustment for potential confounders. The area under the receiver operating characteristic curve of uRenCR for discrimination of AKI stage 3 was 0.805, and PICU mortality was 0.801. CONCLUSIONS Urinary renin was associated with the increased risk for AKI stage 3 and PICU mortality in critically ill children. IMPACT Urinary renin is proposed to be a novel prognostic biomarker of AKI in adult patients. There are some differences between children and adults in physiological and pathophysiological characteristics. This study demonstrated that urinary renin was associated with the increased risk for AKI stage 3 and PICU mortality in critically ill children. Accurate identification of patients with severe renal injury or at high risk for mortality early in the disease course could augment the efficacy of available interventions and improve patient outcomes.
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Affiliation(s)
- Yuxian Kuai
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Hui Huang
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Xiaomei Dai
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Zhongyue Zhang
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Zhenjiang Bai
- Pediatric Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Jiao Chen
- Pediatric Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Fang Fang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Jian Pan
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Xiaozhong Li
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Jian Wang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China
| | - Yanhong Li
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China. .,Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu province, China.
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Prieto MC, Gonzalez AA, Visniauskas B, Navar LG. The evolving complexity of the collecting duct renin-angiotensin system in hypertension. Nat Rev Nephrol 2021; 17:481-492. [PMID: 33824491 PMCID: PMC8443079 DOI: 10.1038/s41581-021-00414-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 02/07/2023]
Abstract
The intrarenal renin-angiotensin system is critical for the regulation of tubule sodium reabsorption, renal haemodynamics and blood pressure. The excretion of renin in urine can result from its increased filtration, the inhibition of renin reabsorption by megalin in the proximal tubule, or its secretion by the principal cells of the collecting duct. Modest increases in circulating or intrarenal angiotensin II (ANGII) stimulate the synthesis and secretion of angiotensinogen in the proximal tubule, which provides sufficient substrate for collecting duct-derived renin to form angiotensin I (ANGI). In models of ANGII-dependent hypertension, ANGII suppresses plasma renin, suggesting that urinary renin is not likely to be the result of increased filtered load. In the collecting duct, ANGII stimulates the synthesis and secretion of prorenin and renin through the activation of ANGII type 1 receptor (AT1R) expressed primarily by principal cells. The stimulation of collecting duct-derived renin is enhanced by paracrine factors including vasopressin, prostaglandin E2 and bradykinin. Furthermore, binding of prorenin and renin to the prorenin receptor in the collecting duct evokes a number of responses, including the non-proteolytic enzymatic activation of prorenin to produce ANGI from proximal tubule-derived angiotensinogen, which is then converted into ANGII by luminal angiotensin-converting enzyme; stimulation of the epithelial sodium channel (ENaC) in principal cells; and activation of intracellular pathways linked to the upregulation of cyclooxygenase 2 and profibrotic genes. These findings suggest that dysregulation of the renin-angiotensin system in the collecting duct contributes to the development of hypertension by enhancing sodium reabsorption and the progression of kidney injury.
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Affiliation(s)
- Minolfa C. Prieto
- Department of Physiology, Tulane University School of Medicine, New Orleans, LA, USA.,Hypertension and Renal Center of Excellence, Tulane University School of Medicine, New Orleans, LA, USA.,
| | - Alexis A. Gonzalez
- Instituto de Química, Pontificia Universidad Católica de Valparaíso, Valparaiso, Chile
| | - Bruna Visniauskas
- Department of Physiology, Tulane University School of Medicine, New Orleans, LA, USA
| | - L. Gabriel Navar
- Department of Physiology, Tulane University School of Medicine, New Orleans, LA, USA.,Hypertension and Renal Center of Excellence, Tulane University School of Medicine, New Orleans, LA, USA
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Visniauskas B, Arita DY, Rosales CB, Feroz MA, Luffman C, Accavitti MJ, Dawkins G, Hong J, Curnow AC, Thethi TK, Lefante JJ, Jaimes EA, Mauvais-Jarvis F, Fonseca VA, Prieto MC. Sex differences in soluble prorenin receptor in patients with type 2 diabetes. Biol Sex Differ 2021; 12:33. [PMID: 33933156 PMCID: PMC8088668 DOI: 10.1186/s13293-021-00374-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/07/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The soluble prorenin receptor (sPRR), a member of the renin-angiotensin system (RAS), is elevated in plasma of patients with preeclampsia, hypertension, chronic kidney disease (CKD), and type 2 diabetes. Our goal was to examine the relationship between sPRR and RAS activation to define whether sexual dimorphisms in sPRR might explain sex disparities in renal outcomes in patients with type 2 diabetes. METHODS Two hundred sixty-nine participants were included in the study (mean age, 48 ± 16 years; 42% men, 58% women), including 173 controls and 96 subjects with type 2 diabetes. In plasma and urine, we measured sPRR, plasma renin activity (PRA), and prorenin. In the urine, we also measured angiotensinogen along with other biomarkers of renal dysfunction. RESULTS Plasma sPRR and PRA were significantly higher in women with type 2 diabetes compared to men. In these women, plasma sPRR was positively correlated with PRA, age, and body mass index (BMI). In contrast, in men the sPRR in urine but not in plasma positively correlated with eGFR in urine, but negatively correlated with urine renin activity, plasma glucose, age, and BMI. CONCLUSIONS In patients with type 2 diabetes, sPRR contributes to RAS stimulation in a sex-dependent fashion. In diabetic women, increased plasma sPRR parallels the activation of systemic RAS; while in diabetic men, decreased sPRR in urine matches intrarenal RAS stimulation. sPRR might be a potential indicator of intrarenal RAS activation and renal dysfunction in men and women with type 2 diabetes.
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Affiliation(s)
- Bruna Visniauskas
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
| | - Danielle Y. Arita
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
| | - Carla B. Rosales
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
| | - Mohammed A. Feroz
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
| | - Christina Luffman
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
| | - Michael J. Accavitti
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
| | - Gabrielle Dawkins
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
| | - Jennifer Hong
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
| | - Andrew C. Curnow
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
| | - Tina K. Thethi
- Department of Medicine, Endocrinology Division, Tulane University School of Medicine, New Orleans, LA USA
- AdventHealth, Translational Research Institute, Orlando, FL USA
| | - John J. Lefante
- Department of Biostatistics and Data Science, School of Public Health and Tropical Medicine, New Orleans, LA USA
| | - Edgar A. Jaimes
- Renal Service, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Franck Mauvais-Jarvis
- Department of Medicine, Endocrinology Division, Tulane University School of Medicine, New Orleans, LA USA
- Southeast Louisiana Veterans Healthcare System, New Orleans, LA USA
- Tulane Center of Excellence in Sex-Based Biology and Medicine, New Orleans, LA USA
| | - Vivian A. Fonseca
- Department of Medicine, Endocrinology Division, Tulane University School of Medicine, New Orleans, LA USA
- Southeast Louisiana Veterans Healthcare System, New Orleans, LA USA
| | - Minolfa C. Prieto
- Department of Physiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL39, New Orleans, LA 70112 USA
- Tulane Hypertension and Renal Center of Excellence, Tulane University School of Medicine, New Orleans, LA USA
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5
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Tang J, Wysocki J, Ye M, Vallés PG, Rein J, Shirazi M, Bader M, Gomez RA, Sequeira-Lopez MLS, Afkarian M, Batlle D. Urinary Renin in Patients and Mice With Diabetic Kidney Disease. Hypertension 2019; 74:83-94. [PMID: 31079532 DOI: 10.1161/hypertensionaha.119.12873] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In patients with diabetic kidney disease (DKD), plasma renin activity is usually decreased, but there is limited information on urinary renin and its origin. Urinary renin was evaluated in samples from patients with longstanding type I diabetes mellitus and mice with streptozotocin-induced diabetes mellitus. Renin-reporter mouse model (Ren1d-Cre;mT/mG) was made diabetic with streptozotocin to examine whether the distribution of cells of the renin lineage was altered in a chronic diabetic environment. Active renin was increased in urine samples from patients with DKD (n=36), compared with those without DKD (n=38; 3.2 versus 1.3 pg/mg creatinine; P<0.001). In mice with streptozotocin-induced diabetes mellitus, urine renin was also increased compared with nondiabetic controls. By immunohistochemistry, in mice with streptozotocin-induced diabetes mellitus, juxtaglomerular apparatus and proximal tubular renin staining were reduced, whereas collecting tubule staining, by contrast, was increased. To examine the role of filtration and tubular reabsorption on urinary renin, mice were either infused with either mouse or human recombinant renin and lysine (a blocker of proximal tubular protein reabsorption). Infusion of either form of renin together with lysine markedly increased urinary renin such that it was no longer different between nondiabetic and diabetic mice. Megalin mRNA was reduced in the kidney cortex of streptozotocin-treated mice (0.70±0.09 versus 1.01±0.04 in controls, P=0.01) consistent with impaired tubular reabsorption. In Ren1d-Cre;mT/mG with streptozotocin-induced diabetes mellitus, the distribution of renin lineage cells within the kidney was similar to nondiabetic renin-reporter mice. No evidence for migration of cells of renin linage to the collecting duct in diabetic mice could be found. Renin mRNA in microdissected collecting ducts from streptozotocin-treated mice, moreover, was not significantly different than in controls, whereas in kidney cortex, largely reflecting juxtaglomerular apparatus renin, it was significantly reduced. In conclusion, in urine from patients with type 1 diabetes mellitus and DKD and from mice with streptozotocin-induced diabetes mellitus, renin is elevated. This cannot be attributed to production from cells of the renin lineage migrating to the collecting duct in a chronic hyperglycemic environment. Rather, the elevated levels of urinary renin found in DKD are best attributed to altered glomerular filteration and impaired proximal tubular reabsorption.
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Affiliation(s)
- Jeannette Tang
- From the Northwestern University Feinberg Medical School, Chicago, IL (J.T., J.W., M.Y., J.R., M.S., D.B.).,Charité-Universitätsmedizin, Berlin, Germany (J.T., J.R., M.S., M.B.)
| | - Jan Wysocki
- From the Northwestern University Feinberg Medical School, Chicago, IL (J.T., J.W., M.Y., J.R., M.S., D.B.)
| | - Minghao Ye
- From the Northwestern University Feinberg Medical School, Chicago, IL (J.T., J.W., M.Y., J.R., M.S., D.B.)
| | - Patricia G Vallés
- Notti Pediatric Hospital School of Medicine, Mendoza, Argentina (P.G.V.)
| | - Johannes Rein
- From the Northwestern University Feinberg Medical School, Chicago, IL (J.T., J.W., M.Y., J.R., M.S., D.B.).,Charité-Universitätsmedizin, Berlin, Germany (J.T., J.R., M.S., M.B.)
| | - Mina Shirazi
- From the Northwestern University Feinberg Medical School, Chicago, IL (J.T., J.W., M.Y., J.R., M.S., D.B.).,Charité-Universitätsmedizin, Berlin, Germany (J.T., J.R., M.S., M.B.)
| | - Michael Bader
- Charité-Universitätsmedizin, Berlin, Germany (J.T., J.R., M.S., M.B.).,Max Delbrück Center for Molecular Medicine, Berlin, Germany (M.B.)
| | | | | | | | - Daniel Batlle
- From the Northwestern University Feinberg Medical School, Chicago, IL (J.T., J.W., M.Y., J.R., M.S., D.B.)
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6
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Salih M, Bovée DM, Roksnoer LCW, Casteleijn NF, Bakker SJL, Gansevoort RT, Zietse R, Danser AHJ, Hoorn EJ. Urinary renin-angiotensin markers in polycystic kidney disease. Am J Physiol Renal Physiol 2017; 313:F874-F881. [PMID: 28747358 DOI: 10.1152/ajprenal.00209.2017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/05/2017] [Accepted: 07/20/2017] [Indexed: 11/22/2022] Open
Abstract
In autosomal dominant polycystic kidney disease (ADPKD), activation of the renin-angiotensin aldosterone system (RAAS) may contribute to hypertension and disease progression. Although previous studies have focused on circulating RAAS components, preliminary evidence suggests that APDKD may increase urinary RAAS components. Therefore, our aim was to analyze circulating and urinary RAAS components in ADPKD. We cross-sectionally compared 60 patients with ADPKD with 57 patients with non-ADPKD chronic kidney disease (CKD). The two groups were matched by sex, estimated glomerular filtration rate (eGFR), blood pressure, and RAAS inhibitor use. Despite similar plasma levels of angiotensinogen and renin, urinary angiotensinogen and renin excretion were five- to sixfold higher in ADPKD (P < 0.001). These differences persisted when adjusting for group differences and were present regardless of RAAS inhibitor use. In multivariable analyses, ADPKD, albuminuria, and the respective plasma concentrations were independent predictors for urinary angiotensinogen and renin excretion. In ADPKD, both plasma and urinary renin correlated negatively with eGFR. Total kidney volume correlated with plasma renin and albuminuria but not with urinary renin or angiotensinogen excretions. Albuminuria correlated positively with urinary angiotensinogen and renin excretions in ADPKD and CKD. In three ADPKD patients who underwent nephrectomy, the concentrations of albumin and angiotensinogen were highest in plasma, followed by cyst fluid and urine; urinary renin concentrations were higher than cyst fluid. In conclusion, this study shows that, despite similar circulating RAAS component levels, higher urinary excretions of angiotensinogen and renin are a unique feature of ADPKD. Future studies should address the underlying mechanism and whether this may contribute to hypertension or disease progression in ADPKD.
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Affiliation(s)
- Mahdi Salih
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Dominique M Bovée
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lodi C W Roksnoer
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Niek F Casteleijn
- Department of Urology, University Medical Center Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands; and
| | - Ronald T Gansevoort
- Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands; and
| | - Robert Zietse
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A H Jan Danser
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ewout J Hoorn
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands;
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7
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Roksnoer LCW, Heijnen BFJ, Nakano D, Peti-Peterdi J, Walsh SB, Garrelds IM, van Gool JMG, Zietse R, Struijker-Boudier HAJ, Hoorn EJ, Danser AHJ. On the Origin of Urinary Renin: A Translational Approach. Hypertension 2016; 67:927-33. [PMID: 26928805 DOI: 10.1161/hypertensionaha.115.07012] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 01/12/2016] [Indexed: 12/18/2022]
Abstract
Urinary angiotensinogen excretion parallels albumin excretion, which is not the case for renin, while renin's precursor, prorenin, is undetectable in urine. We hypothesized that renin and prorenin, given their smaller size, are filtered through the glomerulus in larger amounts than albumin and angiotensinogen, and that differences in excretion rate are because of a difference in reabsorption in the proximal tubule. To address this, we determined the glomerular sieving coefficient of renin and prorenin and measured urinary renin/prorenin 1) after inducing prorenin in Cyp1a1-Ren2 rats and 2) in patients with Dent disease or Lowe syndrome, disorders characterized by defective proximal tubular reabsorption. Glomerular sieving coefficients followed molecular size (renin>prorenin>albumin). The induction of prorenin in rats resulted in a >300-fold increase in plasma prorenin and doubling of blood pressure but did not lead to the appearance of prorenin in urine. It did cause parallel rises in urinary renin and albumin, which losartan but not hydralazine prevented. Defective proximal tubular reabsorption increased urinary renin and albumin 20- to 40-fold, and allowed prorenin detection in urine, at ≈50% of its levels in plasma. Taken together, these data indicate that circulating renin and prorenin are filtered into urine in larger amounts than albumin. All 3 proteins are subsequently reabsorbed in the proximal tubule. For prorenin, such reabsorption is ≈100%. Minimal variation in tubular reabsorption (in the order of a few %) is sufficient to explain why urinary renin and albumin excretion do not correlate. Urinary renin does not reflect prorenin that is converted to renin in tubular fluid.
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Affiliation(s)
- Lodi C W Roksnoer
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - Bart F J Heijnen
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - Daisuke Nakano
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - Janos Peti-Peterdi
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - Stephen B Walsh
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - Ingrid M Garrelds
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - Jeanette M G van Gool
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - Robert Zietse
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - Harry A J Struijker-Boudier
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - Ewout J Hoorn
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.)
| | - A H Jan Danser
- From the Division of Pharmacology and Vascular Medicine (L.C.W.R, I.M.G., J.M.G.v.G., A.H.J.D.), Division of Nephrology and Transplantation (L.C.W.R., R.Z., E.J.H.), Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.F.J.H., H.A.J.S.-B.); Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles (D.N., J. P.-P.); Department of Pharmacology, Kagawa University, Kagawa, Japan (D.N.); and UCL Centre for Nephrology, Royal Free Hospital, London, United Kingdom (S.B.W.).
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