Abstract: SA-PO919
Increased Heart Rate Reflects Intrarenal Renin-Angiotensin System Activation in CKD Patients but Not in Subjects Without CKD
Session Information
- CKD: Clinical, Outcomes, Trials - III
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Ohashi, Naro, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Isobe, Shinsuke, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Ishigaki, Sayaka, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Aoki, Taro, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Matsuyama, Takashi, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Fujikura, Tomoyuki, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Kato, Akihiko, Hamamatsu University Hospital, Hamamatsu, Japan
- Yasuda, Hideo, Hamamatsu University School of Medicine, Hamamatsu, Japan
Background
A higher heart rate is one of the risk factors for heart failure and cardiovascular disease as well as accelerated glomerular filtration rate (GFR) decline. Activation of the intrarenal renin-angiotensin system (RAS) plays an important role in the development of hypertension and renal damage. However, the association between heart rate and intrarenal RAS activation is unclear.
Methods
We investigated the relationship between heart rate and urinary angiotensinogen (AGT) excretion, a surrogate marker for intrarenal RAS activity, in 10 subjects without chronic kidney disease (CKD) [age 50.1 ± 6.4 years, 4 men and 6 women, serum creatinine (sCr) 0.71 ± 0.13 mg/dL, urinary protein excretion 35.6 ± 15.3 mg/day, and urinary AGT excretion 7.22 ± 4.69 μg/day] and 72 CKD patients who were not taking medications that influence heart rate and RAS blockers [age 50.0 ± 17.4 years, 27 men and 45 women, sCr 1.85 ± 2.71 mg/dL, urinary protein excretion 1.27 ± 2.63 g/day, and and urinary AGT excretion 747.4 ± 2714.6 μg/day]
Results
As heart rate is influenced by behavior and emotion, we divided it into daytime and nighttime. Heart rate had a significant positive association with sCr levels during daytime and nighttime in CKD patients but not in non-CKD subjects. Moreover, although heart rate was not associated with urinary AGT excretion levels in non-CKD subjects during daytime (r = 0.39 and p = 0.28) and nighttime (r = 0.34 and p=0.38), it was associated with urinary AGT excretion levels during daytime (r = 0.23 and p = 0.047) and nighttime (r = 0.45 and p <0.01) in CKD patients. Multiple linear regression analysis revealed that heart rate had a significant positive association with the urinary AGT excretion levels during nighttime, but not daytime, after adjustments for age, sex, body mass index, and sCr in CKD patients (β = 0.31 and p = 0.034).
Conclusion
Heart rate is associated with urinary AGT excretion levels, especially during the nighttime, in CKD patients but not in non-CKD subjects. Heart rate measurement may be a convenient surrogate marker for intrarenal RAS activation in CKD patients.
Funding
- Government Support - Non-U.S.