Background: Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary\nkidney diseases that frequently result in renal failure. In this cross-sectional observational cohort study, we evaluated\nurinary angiotensinogen (AGT) as a potential biomarker to assess renal function in ADPKD.\nMethods: Urinary AGT was measured in 233 ADPKD patients and its association with estimated glomerular filtration\nrate (eGFR) and height-adjusted total kidney volume (htTKV) were evaluated. The localization of AGT and other\nrenin-angiotensin system (RAS)-related molecules were identified using immunohistochemistry in human ADPKD tissues.\nResults: Baseline urinary AGT/Cr was negatively correlated with CKD-EPI eGFR (r2 = 0.162, P < 0.001) and positively\ncorrelated with htTKV (r2 = 0.107, P < 0.001). Both urinary AGT/Cr and plasma renin activity levels were significantly\nelevated in hypertensive ADPKD patients. Among hypertensive subjects, urinary AGT/Cr was significantly increased\nin the advanced CKD stages (III-V) compared to early CKD stages (I-II) (28.6 �± 60.3 vs. 93.2 �± 139.3 ?g/g, P < 0.001).\nImmunohistochemical study showed strong expression of AGT along the cyst-lining epithelial cells as well as the\nnearby compressed tubular epithelial cells.\nConclusions: Our results suggested that urinary AGT/Cr may be a valuable biomarker for renal damage in ADPKD\nsince intrarenal ischemic insults induced by cyst growth and subsequent intrarenal RAS activation may play a\npotential role in the development of hypertension and renal dysfunction in ADPKD
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