Role of Local Renin Angiotensin System Activation on Blood Pressure and Residual Renal Function in Peritoneal Dialysis Patients

Özet

Objective: Several studies have shown that local renin–angiotensin system (RAS) activity in the kidneys may play a role inthe pathogenesis of hypertension and kidney damage in patients with chronic kidney disease. In this study, we aimed toinvestigate the effect of local RAS activity on hypertension and residual renal function (RRF) in patients undergoing peritoneal dialysis (PD).Materials and Methods: Fifty patients with residual urine undergoing PD were included in the study. They were dividedinto the hypertensive (n=30) and non-hypertensive (n=20) groups. The urine angiotensinogen-to-creatinine ratio, which isan indicator of local RAS activity, was compared between the two groups. Factors affecting this ratio were also investigated.Results: There was no significant difference in the mean urine angiotensinogen-to-creatinine ratios between the twogroups. A correlation analysis revealed that the urine angiotensinogen-to-creatinine ratio had a significant negative correlation with RRF determined by 24-hour creatinine excretion (r=−0.391, p=0.005). There was a positive correlation betweenthe urine angiotensinogen-to-creatinine ratio with proteinuria (r=0.289, p=0.04) and negative correlation with serum albumin (r=−0.280, p=0.049). However, we could not find any association between the urine angiotensinogen-to-creatinine ratioand blood pressure values.Conclusion: Local RAS activation in the kidney reflected by urinary angiotensinogen is associated with RRF and proteinuriain patients undergoing PD; however, high blood pressure was not correlated with urinary angiotensinogen levels.