Key result
In patients with type 2 diabetes and preserved kidney function, a 1-year increase in urinary angiotensinogen was significantly inversely correlated with the annual change in eGFR (β = -0.37, P=0.001).
Cohort (n=91)
No
Effect estimate: β = -0.37 (95% CI -1.30 to -0.37)
p-value: p=0.001
Increases in urinary angiotensinogen over one year independently predict faster decline in eGFR in type 2 diabetes patients with preserved kidney function, especially those not on RAS blockers.
Urinary angiotensinogen rise was associated with faster eGFR decline in type 2 diabetes; hypothesis-generating for early risk stratification, pending validation.
Urinary angiotensinogen (AGT) is potentially a specific biomarker for the status of the intrarenal renin-angiotensin system (RAS) in patients with diabetes mellitus. We explored whether changes in urinary AGT excretion levels were associated with the deterioration of kidney function in type 2 diabetes patients with preserved kidney function. Urinary baseline AGT levels were measured in 118 type 2 diabetic patients who were not taking RAS blockers and who had estimated glomerular filtration rates (eGFRs) ≥ 60 mL/min/1.73 m². A total of 91 patients were followed-up for 52 months. Changes in urinary levels of AGT (ΔAGT) were calculated by subtracting urinary AGT/creatinine (Cr) at baseline from urinary AGT/Cr after 1 year. ΔAGT was significantly inversely correlated with annual eGFR change (β = -0.29, P = 0.006; β = -0.37, P = 0.001 after adjusting for clinical factors). RAS blockers were prescribed in 36.3% of patients (n = 33) during follow-up. The ΔAGT values were lower in the RAS blockers users than in the non-RAS blockers users, but the differences were not statistically significant (7.37 ± 75.88 vs. 22.55 ± 57.45 μg/g Cr, P = 0.081). The ΔAGT values remained significantly correlated with the annual rate of eGFR change (β = -0.41, P = 0.001) in the patients who did not use RAS blockers, but no such correlation was evident in the patients who did. ΔAGT is inversely correlated with annual changes in eGFR in type 2 diabetes patients with preserved kidney function, particularly in RAS blocker-naïve patients.
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Lee et al. (2017) conducted a cohort in Type 2 Diabetes Mellitus (n=91). Change in urinary angiotensinogen (ΔAGT) was evaluated on Annual rate of eGFR change (β = -0.37, 95% CI -1.30 to -0.37, p=0.001). In patients with type 2 diabetes and preserved kidney function, a 1-year increase in urinary angiotensinogen was significantly inversely correlated with the annual change in eGFR (β = -0.37, P=0.001).
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