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Urinary excretion of components of the renin-angiotensin-aldosterone system in patients having localized renal cancer.

e14725 Background: The aim of the study was exploring the content of components of the renin-angiotensin-aldosterone system (RAAS) in the urine of renal cancer (RC) patients depending on the clinical and morphological characteristics. Methods: In the urine of patients having localized renal cancer Т1N0M0 (the main group, n = 40) the level of angiotensinII (ATII), angiotensin-converting enzymes (ACE and ACE2) was studied by the ELISA with excretable creatinine taken into account in order to eliminate the differences of diuresis. The control group was made up of 35 healthy donors. Results: In patients of the main group, the content of ATP in the urine is 71,5% higher (р = 0,003) than in the healthy donors. In 50% of the patients, the range of fluctuations of ATI in the urine from the lower to the upper quartile amounts to 4,2-9,8 pg/µmol of creatinine against 2,1-5,2 pg/µmol of creatinine in the healthy ones.The level of ACE and ACE2 in the patients as compared to the healthy donors is also 35,4% and 24,5% higher, respectively (at p < 0,05). The proportion of increment ΔATII/ΔACE in the patients amounted to 2,2±0,1as compared to the healthy donors, that of ΔATII/ΔACE2 – to3,2±0,2. Meanwhile, ΔACE/ΔACE2 was 1,6±0,1, which confirms the predominance of the activity of ACE. In patients of the main group, no statistically valid difference of the urinary excretion value of ATII, ACE and ACE2 has been identified between the subgroups depending on the RC stage T1a, Т1bas well as on dimensions of the tumor nodes. However, in case of the RC with G2 tumor differentiation grade as compared to the G1, the content of ATII, ACE and ACE2 in the urine is 3,5; 2,5 and 2,1 times higher, respectively (p < 0,05). Conclusions: In patients having localized renal cancer, increased urinary excretion of components of the renin-angiotensin-aldosterone system has been found. The content of angiotensin II in the urine exceeds the activity of angiotensin-converting enzymes, which may be related to the alternative ways of its formation under tumor growth. The content of the RAAS components in the urine in patients having localized renal cancer does not depend on the stage and dimensions of the tumor but it correlates with the differentiation grade.