Key result
Primary hypertension in children and adolescents was associated with significantly higher urine renin-to-creatinine ratios compared to normotensive controls (6.99 vs. 2.93 pg/mg, p=0.003).
Why the study?
Hypertension is emerging in youth and the renin-angiotensin system regulates blood pressure, but whether intrarenal activation occurs in hypertensive children and whether urine AGT or urine REN better reflects this activity remained unclear.
Does urine renin or angiotensinogen excretion correlate with blood pressure in children and adolescents with primary hypertension?
Case-Control (n=87)
No
Does urine renin or angiotensinogen excretion correlate with blood pressure in children and adolescents with primary hypertension?
Increased urine renin excretion correlates with diastolic blood pressure in hypertensive children, suggesting a role for the intrarenal renin-angiotensin system in pediatric primary hypertension.
Urine renin excretion was associated with pediatric hypertension; leaves open its role as intrarenal RAS marker pending prospective validation.
Introduction In recent years hypertension has become an emerging condition in the young population. It has been proposed that the renin–angiotensin system plays an important role in regulation of blood pressure. We assessed whether activation of the intrarenal renin-angiotensin system occurs in hypertensive children and adolescents and what better reflects its activity: urine angiotensinogen (AGT) or urine renin (REN). Material and methods The study was conducted on a sample of 58 subjects with primary hypertension (HT) and 29 normotensive children and adolescents. We measured urine REN and AGT excretion and assessed the values in relation to blood pressure (BP) and other clinical parameters. Both REN and AGT values were calculated by urine creatinine: REN/cr. and AGT/cr., respectively. Results We observed higher urine REN/cr. values in hypertensive subjects in comparison to the reference group (6.99 vs. 2.93, p = 0.003). Hypertensive participants showed positive correlations between urine REN/cr. and diastolic 24-hour BP (r = 0.42, p = 0.002) as well as between urine REN/cr. and urine AGT/cr. (r = 0.266, p = 0.044, respectively). Conclusions Increased urine REN/cr. in hypertensive children and adolescents and its positive correlation with BP may indicate its important role in the pathogenesis of HT. Perhaps urine REN/cr. could be a marker of intrarenal renin-angiotensin system activity. Nevertheless, further research should be undertaken to confirm this observation.
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Zajaç et al. (2019) conducted a case-control in Primary hypertension (n=87). Primary hypertension vs. Normotensive children and adolescents was evaluated on Urine renin-to-creatinine ratio (REN/cr.) (p=0.003). Primary hypertension in children and adolescents was associated with significantly higher urine renin-to-creatinine ratios compared to normotensive controls (6.99 vs. 2.93 pg/mg, p=0.003).
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