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Albuminuria as a cause of hypertension

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A genetic study using a Mendelian randomization approach provides evidence that albuminuria — as well as being the result of hypertension — might also cause hypertension and cardiometabolic disease. We suggest that a mechanism behind these findings could involve sodium retention by urinary protein-induced activation of the epithelial sodium channel in the distal tubule.

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Fig. 1: Association of albuminuria with incident disease end points plotted against association of genetic predisposition to increased albuminuria with incident disease.

References

  1. Remuzzi, G. & Bertani, T. Is glomerulosclerosis a consequence of altered glomerular permeability to macromolecules? Kidney Int. 38, 384–394 (1990).

    Article  CAS  Google Scholar 

  2. Brantsma, A. H. et al. Urinary albumin excretion as a predictor of the development of hypertension in the general population. J. Am. Soc. Nephrol. 17, 331–335 (2006).

    CAS  PubMed  Google Scholar 

  3. Chronic Kidney Disease Prognosis Consortium et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet 375, 2073–2081 (2010).

    Article  Google Scholar 

  4. Haas, M. E. et al. Genetic association of albuminuria with cardiometabolic disease and blood pressure. Am. J. Hum. Genet. 103, 461–473 (2018).

    Article  CAS  Google Scholar 

  5. Vaez, A. et al. lodGWAS: a software package for genome-wide association analysis of biomarkers with a limit of detection. Bioinformatics 32, 1552–1554 (2016).

    Article  CAS  Google Scholar 

  6. Gansevoort, R. T. et al. Antiproteinuric effect of blood-pressure-lowering agents: a meta-analysis of comparative trials. Nephrol. Dial. Transplant. 10, 1963–1974 (1995).

    Article  CAS  Google Scholar 

  7. Heerspink, H. J. et al. Drug-induced reduction in albuminuria is associated with subsequent renoprotection: a meta-analysis. J. Am. Soc. Nephrol. 26, 2055–2064 (2015).

    Article  CAS  Google Scholar 

  8. Bohnert, B. N. et al. Aprotinin prevents proteolytic epithelial sodium channel (ENaC) activation and volume retention in nephrotic syndrome. Kidney Int. 93, 159–172 (2018).

    Article  CAS  Google Scholar 

  9. Hinrichs, G. R. et al. Albuminuria in kidney transplant recipients is associated with increased urinary serine proteases and activation of the epithelial sodium channel. Am. J. Physiol. Renal Physiol. 315, F151–F160 (2018).

    Article  CAS  Google Scholar 

  10. Buhl, K. B. et al. Plasmin in urine from patients with type 2 diabetes and treatment-resistant hypertension activates ENaC in vitro. J. Hypertens. 32, 1672–1677 (2014).

    Article  CAS  Google Scholar 

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Correspondence to Ron T. Gansevoort or Harold Snieder.

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Gansevoort, R.T., Snieder, H. Albuminuria as a cause of hypertension. Nat Rev Nephrol 15, 6–8 (2019). https://doi.org/10.1038/s41581-018-0073-8

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