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Updated: Jul 9, 2026

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Published on: May 2, 2025

Urinary angiotensinogen as a novel mortality predictor in diabetic kidney disease: a propensity-matched analysis from

Sang Heon Suh1,2, Dohyeon Lee3, Hong Sang Choi1,2

  • 1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.

Clinical Kidney Journal
|July 8, 2026
PubMed

Insights

Urinary angiotensinogen (UAGT/Cr) predicts mortality in diabetic kidney disease (DKD) patients but not in those without diabetes. This finding highlights UAGT/Cr as a potential biomarker for stratifying mortality risk in DKD.

Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiovascular Research

Background:

  • Diabetic kidney disease (DKD) significantly increases mortality risk.
  • Current biomarkers lack precision for stratifying mortality risk in DKD.
  • Intrarenal renin-angiotensin-aldosterone system (RAAS) activity is implicated in DKD progression.

Purpose of the Study:

  • To investigate urinary angiotensinogen (UAGT) as a predictor of all-cause mortality in chronic kidney disease (CKD) patients with and without diabetes.
  • To determine if UAGT reflects intrarenal RAAS activity and its association with mortality risk.
  • To assess the utility of UAGT/Cr for risk stratification in DKD.

Main Methods:

  • Prospective cohort study of 824 propensity score-matched CKD patients (412 with diabetes, 412 without).
  • Baseline urinary angiotensinogen-to-creatinine ratio (UAGT/Cr) categorized into quintiles.
  • Cox proportional hazards models used to estimate adjusted hazard ratios (HRs) for all-cause mortality.

Main Results:

  • UAGT/Cr independently predicted all-cause mortality in diabetic CKD patients (highest quintile HR 3.61, P < .001).
  • A monotonic relationship was observed between UAGT/Cr and mortality in diabetic patients.
  • No significant association between UAGT/Cr and mortality was found in non-diabetic CKD patients (P for interaction < .001).

Conclusions:

  • Urinary angiotensinogen-to-creatinine ratio (UAGT/Cr) is an independent predictor of all-cause mortality specifically in CKD patients with diabetes.
  • UAGT/Cr shows potential as an etiology-specific prognostic biomarker for risk stratification in diabetic kidney disease.
  • Findings suggest intrarenal RAAS activity, reflected by UAGT/Cr, plays a critical role in DKD mortality.
Abstract

Keywords:
angiotensinogenbiomarkerschronic renal insufficiencydiabetes mellitusmortality

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