Key result
Unilateral nephrectomy in living kidney donors increased urinary angiotensinogen levels, which correlated with urinary protein/creatinine ratio at 12 months (r=0.639, P=0.008).
Why the study?
Does unilateral nephrectomy increase urinary angiotensinogen levels and affect renal function in living kidney donors?
Cohort (n=20)
Does unilateral nephrectomy increase urinary angiotensinogen levels and affect renal function in living kidney donors?
Unilateral nephrectomy in living kidney donors leads to sustained increases in urinary angiotensinogen levels and decreased eGFR up to 1 year, suggesting activation of the intrarenal renin-angiotensin system.
Post-nephrectomy uAGT rise may signal intrarenal RAS activation in donors; leaves open long-term renal outcome implications.
BACKGROUND: Urinary angiotensinogen (uAGT) has recently been proposed as a marker of kidney injury and activated intrarenal renin-angiotensin system. We investigated the effects of living donor nephrectomy on uAGT levels, blood pressure, estimated glomerular filtration rate, proteinuria and compensatory hypertrophy in the remaining kidney of living kidney donors. METHODS: Twenty living kidney donors were included in the study and followed for 1 year. uAGT levels were measured with enzyme-linked immunosorbent assay preoperatively and postoperatively at the 15th day, 1, 6 and 12 months. RESULTS: Four donors were excluded from the study due to lack of data. The mean baseline estimated glomerular filtration rate was 98 ± 15 ml/min/1.73 m². Serum creatinine, uAGT/creatinine, uAGT/protein levels were higher and estimated glomerular filtration rate was lower than baseline values at all time periods. Urinary protein/creatinine levels increased after donor nephrectomy, but after 6 months they returned to baseline values. Renal volume increased after nephrectomy, but these changes did not show any correlation with uAGT/creatinine, uAGT/protein, estimated glomerular filtration rate or systolic/diastolic blood pressures. uAGT/creatinine at 6 months and urinary protein/creatinine ratio at 12 months showed a positive correlation ( P=0.008, r=0.639). CONCLUSION: After donor nephrectomy, increasing uAGT levels can be the result of activation of the intrarenal renin-angiotensin system affecting the compensatory changes in the remaining kidney. The long-term effects of increased uAGT levels on the remaining kidney should be examined more closely in future studies.
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Çelebi et al. (2017) conducted a cohort in Living kidney donors (n=20). Unilateral nephrectomy vs. Baseline (preoperative) was evaluated on Urinary angiotensinogen (uAGT) levels. Unilateral nephrectomy in living kidney donors increased urinary angiotensinogen levels, which correlated with urinary protein/creatinine ratio at 12 months (r=0.639, P=0.008).
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