URINARY CYCLIC ADENOSINE MONOPHOSPHATE (CAMP) AND KALLIKREIN ACTIVITY (UKA) AS PROGRESSION MARKERS IN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE (ADPKD)

ODDO, E.; PERONI, RN; ROSEMBERG, ML; FRAGA, AR; SOSA, MH; AZURMENDI, P

Mar del Plata

Congreso; LXIII Reunión Anual de la Sociedad Argentina de Investigación Clínica; 2018

Sociedad Argentina de Investigación Clínica

ADPKD is characterized by both hypertension and cyst growth that deteriorate kidney function over decades of disease progression. The kallikrein-kinin system is involved in blood pressure regulation and UKa is a marker of its renal activity. In addition, vasopressin- renal V2 receptor axis promote cystic expansion through intracellular cAMP pathway activation. Our preliminary data has shown altered urine UKa compared to controls as well as that plasma vasopressin levels correlated with total kidney volume (TKV) and GFR. In order to evaluate UKa behavior over time and urine cAMP levels, daily UKa (U/d) was measured by amidolytic method in a 3-years follow-up of 12 ADPKD (35 ± 1 years, 5 women) and urine cAMP (nmol/g Cr) was determined by radioligand binding assay in a cohort of 9 patients and 5 controls. The data were compared with TKV, GFR, albuminuria, daily osmolal excretion, blood pressure and antihypertensive treatment. Daily UKa increased over time (1.9 ± 0.7 U per year, p = 0.02 paired-T test) and correlated with daily osmolal excretion (spearman r = 0.7, p = 0.02). Urinary cAMP was higher in ADPKD as compared to controls (4.1 ± 0.4 vs 0.8 ± 0.3, p = 0.002). No clear association with clinical variables was found, except on patients with GFR > 70 ml/min/1.73 m2 that showed cAMP levels