Document Detail

Increased urinary protein excretion in the "normal" range is associated with increased renin-angiotensin system activity.
MedLine Citation:
PMID:  22088437     Owner:  NLM     Status:  MEDLINE    
Increased levels of albuminuria and proteinuria, both linked to augmented renin-angiotensin system (RAS) activity, are associated with adverse kidney and cardiovascular events. However, the relationship between variations in urinary albumin excretion (UAE) and total protein excretion (UTPE) in the normal range and RAS activity is unclear. We examined the association between UAE and UTPE and the hemodynamic response to angiotensin II (ANG II) challenge, a well-accepted indirect measure of RAS activity, in healthy individuals with normal UAE and UTPE. Forty subjects (15 men, 25 women; age 38 ± 2 yr; UAE, 3.32 ± 0.55 mg/day; UTPE, 56.8 ± 3.6 mg/day) were studied in high-salt balance. Blood pressure (BP), arterial stiffness determined by applanation tonometry, and circulating RAS components were measured at baseline and in response to graded ANG II infusion. The primary outcome was the BP response to ANG II challenge at 30 and 60 min. UAE was associated with a blunted diastolic BP response to ANG II infusion (30 min, P = 0.005; 60 min, P = 0.17), a relationship which remained even after adjustment (30 min, P < 0.001; 60 min, P = 0.035). Similar results were observed with UTPE (30 min, P = 0.031; 60 min, P = 0.001), even after multivariate analysis (30 min, P = 0.008; 60 min, P = 0.001). Neither UAE nor UTPE was associated with systolic BP, circulating RAS components, or arterial stiffness responses to ANG II challenge. Among healthy individuals with UAE and UTPE in the normal range, increased levels of these measures were independently associated with a blunted diastolic BP response to ANG II, indicating increased vascular RAS activity, which is known to be deleterious to both renal and cardiac function.
David D M Nicholl; Brenda R Hemmelgarn; Tanvir C Turin; Jennifer M MacRae; Daniel A Muruve; Darlene Y Sola; Sofia B Ahmed
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-11-16
Journal Detail:
Title:  American journal of physiology. Renal physiology     Volume:  302     ISSN:  1522-1466     ISO Abbreviation:  Am. J. Physiol. Renal Physiol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-29     Completed Date:  2012-07-19     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  100901990     Medline TA:  Am J Physiol Renal Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  F526-32     Citation Subset:  IM    
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
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MeSH Terms
Albuminuria / physiopathology*
Angiotensin II / pharmacology
Blood Pressure / drug effects,  physiology
Hemodynamics / drug effects,  physiology*
Middle Aged
Proteinuria / physiopathology*
Renin-Angiotensin System / drug effects,  physiology*
Vascular Resistance / drug effects,  physiology
Reg. No./Substance:
11128-99-7/Angiotensin II

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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