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Kidney Week

Abstract: FR-PO209

Urinary Angiotensinogen Predicts Progressive CKD After an Episode of AKI

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Author

  • Cao, Wei, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, GUangDong, China
Background

One of the major obstacles to prevent AKI-CKD transition is the lack of effective methods to follow and predict the ongoing kidney injury in AKI survivors.

Methods

In this study, we test the utility of urinary angiotensinogen (UAGT) for dynamically evaluating renal structural changes and predicting AKI-CKD progression by using both mild and severe bilateral renal ischemia/reperfusion injury mice. Furthermore, we evaluated the value of UAGT in predicting AKI-CKD progression in patients with acute tubular necrosis.

Results

UAGT returns to pre-ischemic levels 14 days after mild AKI followed by kidney architecture restoration, whereas sustained increase in UAGT accompanies by ongoing renal fibrosis after severe AKI. UAGT at day 14-42 correlates with renal fibrosis 84 days after AKI. For predicting fibrosis at day 84, the area under receiver operating characteristics curve of UAGT at day 14 is 0.81. Persistent elevation in UAGT correlates with sustained activation of intrarenal renin-angiotensin system (RAS). Abrogating RAS activation markedly reduced fibrosis, consistent with a role of kidney RAS activation in AKI-CKD progression. Moreover, RAS intervention early in the course of AKI-CKD transition is more beneficial than late intervention in reducing renal fibrosis. Similar changes in the UAGT were observed in patients with AKI-CKD transition.

Conclusion

Our study suggests the potential use of UAGT in motoring renal structural recovery over time and the beneficial effect of early RAS intervention in reducing fibrosis after renal function recovery from AKI.