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首页> 外文期刊>Renal failure. >Vitamin D receptor activation with calcitriol for reducing urinary angiotensinogen in patients with type 2 diabetic chronic kidney disease
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Vitamin D receptor activation with calcitriol for reducing urinary angiotensinogen in patients with type 2 diabetic chronic kidney disease

机译：骨化三醇激活维生素D受体以减少2型糖尿病慢性肾脏病患者的尿血管紧张素原

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Background Recently, it has been reported that urinary angiotensinogen levels is a specific index of the intrarenal renin-angiotensin-aldosterone system (RAAS) status and it is significantly correlated with urinary albumin: creatinine (Cr) ratio in hypertensive patients. The aim of the present study was to assess the effect of activation of the Vitamin D receptor with calcitriol on albuminuria and urinary angiotensinogen as a novel biomarker of the intra-renal RAAS status in patients with diabetic nephropathy (DN). Methods Ninety-eight patients with type 2 diabetes and albuminuria who were treated with RAAS inhibitors (angiotensin-converting enzyme inhibitor (ACE-i) or angiotensin receptor blocker (ARB)) have participated in this study. Patients were randomized to receive either placebo (n = 50) or 0.25 mu g/day calcitriol (n = 48). We have examined urinary albumin: Cr ratio and urinary angiotensinogen: Cr ratio before and 24 weeks later after treatment in both group. Results The mean urinary albumin: Cr ratio and urinary angiotensinogen: Cr ratio were significantly higher in patients with DN than in normal controls (p<0.001). Urinary angiotensinogen: Cr ratio was significantly, positively correlated with urinary albumin: Cr ratio in both groups (in the placebo group; p = 0.01, r = 0.4236, in calcitriol group; p = 0.01, r = 0.4564). Conclusion These data indicated that administration of Vitamin D receptor activator in combination with RAAS inhibitors had an additional benefit in lowering albuminuria in patients with DN. More pronounced reduction of urinary albumin: Cr ratio that was positively correlated with angiotensinogen: Cr ratio in calcitriol group suggested that Vitamin D receptor activation might blunt albuminuria by reducing urinary angiotensinogen levels reflecting intra-renal RAAS status.
机译：背景技术最近，有报道说，尿中血管紧张素原水平是肾内肾素-血管紧张素-醛固酮系统（RAAS）状态的特定指标，并且与高血压患者的尿白蛋白：肌酐（Cr）比显着相关。本研究的目的是评估钙三醇激活维生素D受体对白蛋白尿和尿血管紧张素原的影响，作为糖尿病肾病（DN）患者肾内RAAS状态的新生物标记。方法接受RAAS抑制剂（血管紧张素转换酶抑制剂（ACE-i）或血管紧张素受体阻滞剂（ARB））治疗的98例2型糖尿病和蛋白尿患者。患者随机接受安慰剂（n = 50）或0.25μg /天的骨化三醇（n = 48）。我们在两组治疗前和治疗后24周检查了尿白蛋白：Cr比和尿血管紧张素原：Cr比。结果DN患者的平均尿白蛋白：Cr比和尿血管紧张素原：Cr比明显高于正常对照组（p <0.001）。两组的尿中血管紧张素原：Cr比率均与尿白蛋白：Cr比率显着正相关（安慰剂组;骨化三醇组p = 0.01，r = 0.4236; p = 0.01，r = 0.4564）。结论这些数据表明，将维生素D受体激活剂与RAAS抑制剂联合使用可进一步降低DN患者的蛋白尿。骨化三醇组中尿白蛋白：Cr比值的降低更为明显，与血管紧张素原：Cr比值呈正相关，这表明维生素D受体的活化可能通过降低反映肾内RAAS状态的尿道血管紧张素原水平而钝化白蛋白尿。

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