Urinary Albumin Excretion and Atherosclerosis in Essential Hypertension

1997 ◽  
Vol 92 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Roberto Pedrinelli ◽  
Klaus Undpaintner ◽  
Giulia Dell'omo ◽  
Vinicio Napoli ◽  
Vitantonio Di Bello ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Angiotensin Converting Enzyme ◽  
Systolic Blood Pressure ◽  
Urinary Albumin Excretion ◽  
Urinary Albumin ◽  
Cardiac Mass ◽  
Converting Enzyme ◽  
Albumin Excretion ◽  
Angiotensin Converting Enzyme Genotype

1. Increased urinary albumin excretion is common in patients with essential hypertension and is at least to some extent correlated with prevailing blood pressure levels. However, the generalized vascular dysfunction present in advanced atherosclerotic disease may independently influence this parameter. 2. To evaluate this possibility, we assessed blood pressure, ultrasonographic carotid thickness, cardiac mass, minimum forearm vascular resistances, metabolic parameters and the angiotensin-converting enzyme genotype in patients with untreated essential hypertension and atherosclerotic peripheral vascular disease (n = 11). The results were compared with similar data obtained in matched groups of patients with uncomplicated hypertension and with normotensive control subjects (n = 11 per group). 3. Urinary albumin excretion was higher in hypertensive patients with atherosclerosis than in those without complications; carotid thickness was higher in atherosclerotic patients and a positive, statistically significant correlation existed between this parameter and urinary albumin excretion. In the same patient group, systolic blood pressure, fasting insulin and triacylglycerol levels were elevated and correlated with urinary albumin levels. However, differences in urinary albumin excretion persisted after taking into account the influence of those parameters by analysis of covariance. The distribution of angiotensin-converting enzyme genotype patterns and values of cardiac mass and minimum forearm vascular resistances did not differ significantly among the experimental groups. 4. The data suggest that vascular status may influence urinary albumin excretion in patients with essential hypertension, while confirming the importance of systolic blood pressure levels as a determinant of the raised urinary albumin excretion.

Abstract 379: Insulin Attenuated Albuminuria by Upregulating Angiotensin Converting Enzyme 2 (ACE2) in Type 1 Diabetic Akita Mice

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Esam Salem ◽  
Hari K Somineni ◽  
Harshita Chodavarapu ◽  
Mariana Morris ◽  
Khalid M Elased
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Urinary Albumin Excretion ◽  
Renin Angiotensin System ◽  
Urinary Albumin ◽  
Converting Enzyme ◽  
Diabetic Kidney ◽  
Angiotensin Converting Enzyme 2 ◽  
Albumin Excretion ◽  
Akita Mice

Diabetic nephropathy (DN) is a microvascular complication of diabetes that is clinically diagnosed by a progressive increase in albuminuria. Alterations within renin angiotensin system balance contribute to the pathogenesis of diabetic kidney disease. Angiotensin converting enzyme 2 (ACE2), a metallocarboxypetidase, has a renoprotective role due to its ability to form Angiotensin (1-7) [Ang-(1-7)] by degrading Angiotensin II (Ang II). Accumulating evidence shows that strict glycemic control attenuates diabetic kidney damage. Therefore, the aim of this study is to test the hypothesis that normalizing hyperglycemia with insulin will reduce albuminuria by increasing ACE2 in Akita diabetic mice. Type 1 diabetic Akita mice (C57BL/6-Ins2Akita/J) and their wild type (WT) littermates were used. Metabolic parameters were monitored weekly. Urine was collected over 24 hours to measure the urinary albumin, total protein and ACE2 activity. Akita mice developed significant hyperglycemia (Akita: 452±6; WT: 118±2 mg/dL), hypoinsulinemia (Akita: 0.5; WT: 1.5 ng/mL) and hypoadiponectinemia (Akita: 3.0; WT: 6.0 μg/mL) compared to WT mice. There was a significant increase in urinary albumin excretion (Akita: 2.1±0.2; WT: 0.2±0.06 mg/day) in Akita mice compared to WT mice. In addition, Akita mice demonstrated a significant decrease in renal (Akita: 3±0.3; WT: 4.1±0.1 pmol/hr/μg protein) and urinary (Akita: 0.2±0.03; WT: 0.7±0.1 pmol/hr/μg protein) ACE2 activity compared to WT mice (P<0.05). Western blot & immunohistochemistry revealed downregulation of renal ACE2 & nephrin protein expression in Akita mice compared to WT mice. Treatment with insulin implants (LinβitR) for 10 weeks significantly decreased hyperglycemia in Akita mice (treated: 135±21; untreated: 452±6 mg/dL). Insulin treatment significantly decreased urinary albumin excretion (treated: 0.18±0.2; untreated: 2.1±0.2 mg/day) and increased urinary ACE2 activity (treated: 1.3±0.3; untreated: 0.2±0.03 pmol/hr/μg protein) in Akita mice. In conclusion, normalizing hyperglycemia in Akita mice with insulin increased ACE2 activity and attenuated albuminuria.

Inhibition of angiotensin-converting enzyme reduces urinary albumin excretion but not regional albumin clearance in experimental diabetes

1993 ◽  
Vol 240 (2-3) ◽  
pp. 207-212 ◽  
Author(s):  
Maya Huijberts ◽  
Bruce Wolffenbuttel ◽  
Francy Crijns ◽  
Arie Nieuwenhuijzen Kruseman ◽  
Marc Bemelmans ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Urinary Albumin Excretion ◽  
Experimental Diabetes ◽  
Urinary Albumin ◽  
Converting Enzyme ◽  
Albumin Excretion ◽  
Albumin Clearance

scholarly journals Effect of Combination Therapy with a Calcium Channel Blocker and an Angiotensin-Converting Enzyme Inhibitor on Renal Hypertrophy and Urinary Albumin Excretion in Diabetic Rats

2003 ◽  
Vol 4 (3) ◽  
pp. 191-199 ◽  
Author(s):  
Birgitte Nielsen ◽  
Henning Grønbæk ◽  
Ruth Østerby ◽  
Allan Flyvbjerg
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Urinary Albumin Excretion ◽  
Placebo Treatment ◽  
Diabetic Rats ◽  
Urinary Albumin ◽  
Converting Enzyme ◽  
Albumin Excretion

The objective of this study was to compare the effect of an angiotensin-converting enzyme (ACE) inhibitor and a calcium channel blocker on the development of renal changes in diabetic rats. Diabetes was induced by an intravenous injection of streptozotocin in normotensive Wistar rats. Treatment was commenced immediately in 1 set of rats with 4 treatment arms: nitrendipine (250 mg/kg fodder), enalapril (35 mg/L drinking water), both treatments in combination, or placebo. Treatment was continued for 9 weeks. Another set of rats was left with untreated diabetes for 3 months followed by 7 weeks treatment as above. When starting treatment right after induction of diabetes, nitrendipine significantly reduced urinary albumin excretion (UAE) to the nondiabetic level (P< .05) without reducing blood pressure (BP), whereas enalapril failed to significantly reduce UAE despite a reduction in BP. Combining the two treatments showed no further reduction in UAE compared to monotherapy with nitrendipine, despite a lower BP. When leaving diabetic rats untreated for 3 months, only the coadministration of nitrendipine and enalapril showed a significant reduction in UAE compared to monotherapy and placebo treatment, but showed no significant effect on BP.

scholarly journals Urinary Albumin Excretion Is Associated With Nocturnal Systolic Blood Pressure in Resistant Hypertensives

Hypertension ◽  
2011 ◽  
Vol 57 (3) ◽  
pp. 556-560 ◽  
Author(s):  
Anna Oliveras ◽  
Pedro Armario ◽  
Nieves Martell-Clarós ◽  
Luis M. Ruilope ◽  
Alejandro de la Sierra
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Urinary Albumin Excretion ◽  
Urinary Albumin ◽  
Albumin Excretion

Non-diabetic microalbuminuria in clinical practice and its relationship to posture, exercise and blood pressure

1991 ◽  
Vol 81 (3) ◽  
pp. 373-377 ◽  
Author(s):  
J. N. W. West ◽  
P. Gosling ◽  
S. B. Dimmitt ◽  
W. A. Littler
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Chest Pain ◽  
Systolic Blood Pressure ◽  
Urinary Albumin ◽  
Creatinine Ratio ◽  
Clinic Blood Pressure ◽  
Albumin Creatinine Ratio ◽  
Albumin Excretion ◽  
The Relationship

1. The effects of posture and exercise on the relationship between low-level urinary albumin excretion (microalbuminuria) and blood pressure was investigated in two groups of non-diabetic patients at increased cardiovascular risk: 21 otherwise healthy patients with untreated essential hypertension (blood pressure > 160/90 mmHg), and 14 age-matched patients with blood pressure at presentation within the normotensive range (< 160/90 mmHg) attending a cardiovascular clinic for assessment of chest pain. 2. A significant linear relationship between logarithmically transformed ‘spot’ urinary albumin/creatinine ratio and simultaneous clinic blood pressure existed when data from both groups of patients were analysed (r = 0.58, P < 0.05). The relationship between the scatter plot of blood pressure and the albumin/creatinine ratio appeared most marked when the mean blood pressure exceeded 120 mmHg. 3. In patients with essential hypertension, clinic systolic blood pressure was related to the albumin/creatinine ratio in simultaneous ‘spot’ urine samples (r = 0.69, P < 0.05) and also to the albumin/creatinine ratio in early-morning urine samples (r = 0.51, P < 0.05). However, the relationship between clinic blood pressure and simultaneous ‘spot’ urinary albumin/creatinine ratio in the patients with chest pain did not achieve significance when analysed independently. 4. Hourly averaged ambulatory intra-arterial blood pressure was recorded in four of the patients with essential hypertension during normal daytime activity, and a significant correlation with the simultaneous hourly daytime urinary albumin/creatinine ratio was found (r = 0.65, P < 0.01). 5. Low-level albumin excretion increased in both groups after exercise: peak systolic blood pressure during exercise was related to the rise in albumin excretion (hypertensive patients, r = 0.68, P < 0.01; normotensive patients, r = 0.66, P < 0.05).

Renal functional reserve in patients with essential hypertension: Effect of inhibition of the renin-angiotensin system

1990 ◽  
Vol 78 (6) ◽  
pp. 585-590 ◽  
Author(s):  
Enrico Valvo ◽  
Patrizia Casagrande ◽  
Valeria Bedogna ◽  
Francesca Dal Santo ◽  
Daniele Alberti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Filtration Rate ◽  
Urinary Albumin Excretion ◽  
Urinary Albumin ◽  
Converting Enzyme ◽  
Functional Reserve ◽  
Hypertensive Patients ◽  
Renal Functional Reserve ◽  
Albumin Excretion ◽  
Protein Load

1. Urinary albumin excretion and the effect of an acute oral protein load (a meat meal) on glomerular filtration rate ('renal functional reserve') were evaluated in 15 essential hypertensive patients with preserved renal function and compared with 12 normal subjects. 2. Seven patients had microalbuminuria (>30 mg/day) that was not correlated with blood pressure values. 3. After an oral protein load, an average increase of 20% in glomerular filtration rate (from 91 ± 19 to 110 ± 27 ml min−1 1.73 m−2) was found in the hypertensive patients. This change was not statistically different from that observed in normal controls (from 102 ± 7 to 124 ± 9 ml min−1 1.73 m−2). The glomerular response in hypertensive patients was independent of age, duration of hypertension, blood pressure, plasma renin activity, urinary albumin excretion and retinal vascular alterations. 4. All patients were re-evaluated after 6 weeks treatment with a new orally active angiotensin-converting enzyme inhibitor, benazepril. Systolic, diastolic and mean blood pressures were lowered in all the patients, but the drug did not affect the glomerular response to acute protein ingestion or the magnitude of urinary albumin excretion. 5. The findings of a normal ‘renal functional reserve’ and a lack of change in both urinary albumin excretion and the glomerular response after angiotensin-converting enzyme inhibition cast doubt on the existence of increased intraglomerular pressure in hypertensive patients.

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