High plasma renin activity is combined with elevated urinary albumin excretion in essential hypertensive patients

Abstract

Background. Several studies suggest that the hyperactivity of the circulating renin-angiotensin system might favor the progression of renal disease in essential hypertension. To elucidate this aspect, we investigated the relationship between plasma renin activity (PRA) and the urinary albumin excretion rate (UAER), an early marker of hypertension-related renal changes, in human essential hypertension. Methods. Ninety nonobese, nondiabetic, nonhyperlipidemic patients with mild-to-moderate essential hypertension (67 males, 23 females; mean age 51.4 ± 6.2 years) were divided into low renin (LR), normal renin (NR), and high renin (HR) subgroups according to individual PRA while they were on a constant NaCl intake (120 mmol NaCl/day). The UAER was assessed during the same NaCl intake. Results. Data showed significantly higher UAER (31.3 ± 12.9 μg/min) in HR (N = 30) than NR (N = 30, 22.7 ± 14.4 μg/min, P < 0.02) and LR patients (N = 30, 21.7 ± 10.8 μg/min, P < 0.01). Conclusions. Our study demonstrates that the UAER is elevated in HR essential hypertensive patients, suggesting that high PRA accelerates the onset of early renal changes in human: essential hypertension.