Effect of Renin-Angiotensin-Aldosterone System Inhibition, Dietary Sodium Restriction, and/or Diuretics on Urinary Kidney Injury Molecule 1 Excretion in Nondiabetic Proteinuric Kidney Disease: A Post Hoc Analysis of a Randomized Controlled Trial
| العنوان: | Effect of Renin-Angiotensin-Aldosterone System Inhibition, Dietary Sodium Restriction, and/or Diuretics on Urinary Kidney Injury Molecule 1 Excretion in Nondiabetic Proteinuric Kidney Disease: A Post Hoc Analysis of a Randomized Controlled Trial |
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| المؤلفون: | Joseph V. Bonventre, Liffert Vogt, Harry van Goor, Henri G. D. Leuvenink, Kevin Damman, Vishal S. Vaidya, Gerjan Navis, Femke Waanders, Inge Hamming |
| المساهمون: | Faculteit Medische Wetenschappen/UMCG, Groningen Institute for Organ Transplantation (GIOT), Lifestyle Medicine (LM), Groningen Kidney Center (GKC), Vascular Ageing Programme (VAP), Cardiovascular Centre (CVC), Nephrology |
| المصدر: | American Journal of Kidney Diseases, 53(1), 16-25. W B SAUNDERS CO-ELSEVIER INC American journal of kidney diseases, 53(1), 16-25. W.B. Saunders Ltd |
| بيانات النشر: | Elsevier BV, 2009. |
| سنة النشر: | 2009 |
| مصطلحات موضوعية: | Male, medicine.medical_treatment, LONG-TERM PROGNOSIS, PROGRESSION, urologic and male genital diseases, angiotensin II type 1 receptor blockade, Renin-Angiotensin System, Hydrochlorothiazide, Hepatitis A Virus Cellular Receptor 1, Diuretics, tubular damage marker, II RECEPTOR BLOCKER, Cross-Over Studies, Membrane Glycoproteins, Proteinuria, Middle Aged, Combined Modality Therapy, Treatment Outcome, Losartan, Nephrology, biomarker, Receptors, Virus, Drug Therapy, Combination, Female, Kidney Diseases, medicine.symptom, medicine.drug, Adult, medicine.medical_specialty, kidney injury molecule 1, NEPHROPATHY, Diet therapy, Urology, KAPPA-B, Nephropathy, GLOMERULONEPHRITIS, Double-Blind Method, Internal medicine, Acetylglucosaminidase, medicine, Humans, N-acetyl-beta-D-glucosaminidase, Antihypertensive Agents, Aged, ACETYL-BETA-GLUCOSAMINIDASE, urogenital system, business.industry, interstitial renal damage, Sodium, Dietary, medicine.disease, Angiotensin II, RENAL-DISEASE, Endocrinology, Renin-angiotensin-aldosterone system, CELLS, Chronic Disease, Diuretic, business, CONVERTING-ENZYME-INHIBITOR, Biomarkers, Kidney disease |
| الوصف: | Background: Tubulointerstitial damage plays an important role in chronic kidney disease (CKD) with proteinuria. Urinary kidney injury molecule 1 (KIM-1) reflects tubular KIM-1 and is considered a sensitive biomarker for early tubular damage. We hypothesized that a decrease in proteinuria by using therapeutic interventions is associated with decreased urinary KIM-1 levels.Study Design: Post hoc analysis of a randomized, double-blind, placebo-controlled, crossover trial.Setting & Participants: 34 proteinuric patients without diabetes from our outpatient renal clinic.Intervention: Stepwise 6-week interventions of losartan, sodium restriction (low-sodium [LS] diet), their combination, losartan plus hydrochlorothiazide (HCT), and the latter plus an LS diet.Outcomes & Measurements: Urinary excretion of KIM-1, total protein, and N-acetyl-beta-D-glucosaminidase (NAG) as a positive control for tubular injury.Results: Mean baseline urine protein level was 3.8 +/- 0.4 (SE) g/d, and KIM-1 level was 1,706 498 ng/d (increased compared with healthy controls; 74 ng/d). KIM-1 level was decreased by using placebo/LS (1,201 388 ng/d; P = 0.04), losartan/high sodium (1,184 +/- 296 ng/d; P = 0.09), losartan/LS (921 +/- 176 ng/d; P = 0.008), losartan/high sodium plus HCT (862 +/- 151 ng/d; P = 0.008) and losartan/LS plus HCT (743 +/- 170 ng/d; P = 0.001). The decrease in urinary KIM-1 levels paralleled the decrease in proteinuria (R = 0.523; P Limitations: Post hoc analysis.Conclusions: Urinary KIM-1 level was increased in patients with nondiabetic CKD with proteinuria and decreased in parallel with proteinuria by using losartan, sodium restriction, their combination, losartan plus HCT, and the latter plus sodium restriction. These results are consistent with the hypothesis of amelioration of proteinuria-induced tubular damage. Long-term studies are warranted to evaluate whether targeting treatment on KIM-1 can improve outcomes in patients with CKD with proteinuria. Am J Kidney Dis 53:16-25. (C) 2008 by the National Kidney Foundation, Inc. |
| تدمد: | 0272-6386 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9b1fac23f1e32166c327ba1021e1294eTest https://doi.org/10.1053/j.ajkd.2008.07.021Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9b1fac23f1e32166c327ba1021e1294e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 02726386 |
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