Urinary Angiotensinogen and Progression of Chronic Kidney Disease: Results from KNOW-CKD Study

Sang Heon Suh; Tae Ryom Oh; Hong Sang Choi; Eun Mi Yang; Chang Seong Kim; Eun Hui Bae; Seong Kwon Ma; Kook-Hwan Oh; Ji Yong Jung; Young Youl Hyun; Soo Wan Kim

doi:10.3390/biom12091280

Urinary Angiotensinogen and Progression of Chronic Kidney Disease: Results from KNOW-CKD Study

Biomolecules. 2022 Sep 10;12(9):1280. doi: 10.3390/biom12091280.

Authors

Affiliations

¹ Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 64169, Korea.
² Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 64169, Korea.
³ Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea.
⁴ Department of Internal Medicine, Gachon University of Medicine and Science, Incheon 21565, Korea.
⁵ Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea.

Abstract

The prognostic value of urinary angiotensinogen (UAGT) in patients with chronic kidney disease (CKD) has not been completely evaluated, although the association of UAGT with renal outcomes has been suggested in specific subsets of CKD. In the present study, to investigate the association of UAGT with renal outcomes in patients with non-dialysis CKD irrespective of the primary cause, a total of 1688 subjects from the Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) were prospectively analyzed. The subjects were divided into the quintile by UAGT to urine creatinine ratio (UAGT/Cr) level. The primary outcomes of interest were composite renal event, which included decline in kidney function and onset of end-stage renal disease during follow-up periods. The median follow-up duration was 6.257 years. Cox regression model analysis unveiled that the risk of composite renal event was significantly higher in the fifth quintile (adjusted hazard ratio 1.528, 95% confidence interval 1.156 to 2.021) compared to that of the first quartile. The association between high UAGT/Cr level and adverse renal outcome remained consistent in sensitivity analyses, including the analysis of the cause-specific hazard model. Subgroup analyses revealed that the association of UAGT level with renal outcomes is modified by certain clinical contexts, such as BMI and albuminuria. In conclusion, high UAGT level is associated with adverse renal outcomes in patients with non-dialysis CKD. Further studies are warranted to elaborate and expand the predictive role of UAGT as a biomarker for renal outcomes in CKD.

Keywords: angiotensinogen; biomarker; chronic kidney disease; end-stage renal disease; estimated glomerular filtration rate.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Angiotensinogen*
Biomarkers / urine
Cohort Studies
Creatinine
Disease Progression
Humans
Renal Insufficiency, Chronic* / etiology

Substances

Biomarkers
Angiotensinogen
Creatinine

Grants and funding

This work was supported by the Research Program funded by the Korea Disease Control and Prevention Agency (2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, 2016E3300200, 2016E3300201, 2016E3300202, 2019E320100, 2019E320101, 2019E320102, and 2022-11-007), by the National Research Foundation of Korea (NRF) funded by the Korea government (MSIT) (NRF-2020R1F1A1074001), and by a grant (BCRI22042, BCRI22079, and BCRI21046) of Chonnam National University Hospital Biomedical Research Institute.