The Intrarenal Renin-angiotensin System Is Activated Immediately after Kidney Donation in Kidney Transplant Donors
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- Ohashi Naro
- Internal Medicine 1, Hamamatsu University School of Medicine, Japan
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- Isobe Shinsuke
- Internal Medicine 1, Hamamatsu University School of Medicine, Japan
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- Matsuyama Takashi
- Internal Medicine 1, Hamamatsu University School of Medicine, Japan
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- Ishigaki Sayaka
- Internal Medicine 1, Hamamatsu University School of Medicine, Japan
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- Suzuki Takahisa
- Urology, Hamamatsu University School of Medicine, Japan
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- Tsuji Takayuki
- Internal Medicine 1, Hamamatsu University School of Medicine, Japan
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- Otsuka Atsushi
- Urology, Hamamatsu University School of Medicine, Japan
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- Kato Akihiko
- Blood Purification Unit, Hamamatsu University School of Medicine, Japan
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- Miyake Hideaki
- Urology, Hamamatsu University School of Medicine, Japan
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- Yasuda Hideo
- Internal Medicine 1, Hamamatsu University School of Medicine, Japan
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抄録
<p>Objective The intrarenal renin-angiotensin system (RAS) is activated in clinical settings, such as chronic kidney disease (CKD), as well as in CKD animal models, and kidney transplant donors have a greater risk of end-stage renal disease than healthy controls. However, whether or not the intrarenal RAS is activated immediately after kidney donation in kidney transplant donors is unclear, and the mechanism underlying intrarenal RAS activation is unknown. </p><p>Methods We investigated 10 kidney transplant donors (4 men and 6 women, 58.6±9.0 years of age). Their blood pressure (BP), estimated glomerular filtration rate (eGFR), plasma angiotensinogen (AGT) and plasma angiotensin II (AngII) levels (which reflect circulating RAS activation), urinary albumin excretion, and urinary AGT excretion (which reflects intrarenal RAS activation) were evaluated before kidney donation (-1.2±0.40 days) and after kidney donation (7.5±1.7 days). </p><p>Results The renal function after kidney donation was significantly lower than before donation. There were no significant differences in the BP during 24-h ambulatory BP monitoring, plasma AngII levels, or urinary albumin excretion after kidney donation. In contrast, the levels of plasma AGT and urinary AGT excretion were significantly increased after kidney donation. The urinary AGT excretion after kidney donation did not show a significant relationship with the systolic BP, plasma AGT, plasma AngII, or urinary albumin excretion. In addition, the percentage change in urinary AGT excretion after kidney donation was not associated with the percentage change in other clinical parameters. </p><p>Conclusion The intrarenal RAS is activated in kidney transplant donors immediately after kidney donation, independent of the systemic BP and filtration of increased plasma AGT, due to augmented inflammation. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 58 (5), 643-648, 2019-03-01
一般社団法人 日本内科学会