The circulating renin-angiotensin-aldosterone system is down-regulated in dogs with glomerular diseases compared to other chronic kidney diseases with low-grade proteinuria

PLoS One. 2022 Jan 10;17(1):e0262121. doi: 10.1371/journal.pone.0262121. eCollection 2022.

Abstract

Glomerular diseases (GD) lead to a variety of disorders of the vascular and the total body water volumes. Various pathomechanisms, including vascular underfill and overfill, have been suggested to explain these disturbances. Accordingly, the circulating renin-angiotensin-aldosterone system (cRAAS) is expected to be activated as either a cause or a result of these fluid disorders. The aim of this study was to characterize the activity of the cRAAS in dogs with GD and to evaluate its relationship with the vascular volume status. In a prospective study, we evaluated the plasma renin activity and the serum aldosterone concentration in 15 dogs with GD. Their fluid volume status was estimated with clinical variables reflecting volemia and hydration, echocardiographic volume assessment, N-terminal pro B-type natriuretic peptide, blood urea nitrogen:creatinine ratio, and the urinary fractional excretion of sodium. Ten dogs with chronic kidney disease (CKD) with matching degree of azotemia were recruited as controls. The activity of the cRAAS was low in 10 dogs, normal in 3 dogs, high in 1 dog and equivocal (high renin-low aldosterone) in 1 dog with GD. These dogs had a lower cRAAS activity than dogs with CKD (p = 0.01). The clinical evaluation showed 8 hypovolemic and 7 non-hypovolemic dogs; 3 dehydrated, 9 euhydrated and 3 overhydrated dogs. The cRAAS activity was not different between hypovolemic and non-hypovolemic dogs. The down-regulated cRAAS without obvious association with the clinical volume status of these dogs with GD, suggests different mechanisms of fluid volume dysregulation in dogs with GD than previously assumed. This finding however should be confirmed in a focused larger scale study, as it may influence the use of cRAAS blockers as part of the standard therapy of GD in dogs.

Publication types

  • Comparative Study

MeSH terms

  • Aldosterone / blood*
  • Animals
  • Atrial Natriuretic Factor / blood
  • Azotemia / blood
  • Azotemia / veterinary*
  • Blood Urea Nitrogen
  • Dog Diseases / blood*
  • Dogs
  • Down-Regulation
  • Female
  • Glomerulonephritis / blood
  • Glomerulonephritis / veterinary*
  • Male
  • Prospective Studies
  • Protein Precursors / blood
  • Proteinuria / blood
  • Proteinuria / veterinary*
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / veterinary*
  • Renin / blood*

Substances

  • N-terminal proatrial natriuretic peptide
  • Protein Precursors
  • Aldosterone
  • Atrial Natriuretic Factor
  • Renin

Grants and funding

We acknowledge a grant from the Specialization Commission of the Vetsuisse Faculty University of Bern funding part of this project (2016). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.