Antihypertensive treatment of end-stage renal disease patients on hemodialysis does not alter circulating ACE and ACE2 activity and angiotensin peptides

• Published in: The American journal of the medical sciences Vol. 367; no. 2; p. 128
• Main Authors: Gomes, Renata Vitoriano Corradi, Peluso, A Augusto, Ronchi, Fernanda Aparecida, de Oliveira, Lilian Caroline Gonçalves, Casarini, Dulce Elena, Santos, Robson Augusto Souza, Endlich, Patrick Wander, de Abreu, Glaucia Rodrigues
• Format: Journal Article
• Language: English
• Published: United States 01.02.2024
• Subjects: Angiotensin II - pharmacology; Angiotensin-Converting Enzyme 2 - pharmacology; Antihypertensive Agents - pharmacology; Antihypertensive Agents - therapeutic use; Chromatography, Liquid; Humans; Kidney Failure, Chronic - drug therapy; Peptide Fragments - metabolism; Peptides - pharmacology; Peptidyl-Dipeptidase A - metabolism; Renal Dialysis; Renin-Angiotensin System; Tandem Mass Spectrometry; Hypertension; Angiotensin-(1–7); Angiotensin II; Hemodialysis; ACE inhibitor; ATR-blocker
• ISSN: 1538-2990
• DOI: 10.1016/j.amjms.2023.11.014

Cardiovascular diseases (CVD) are the main causes of death in hemodialysis patients, representing a public health challenge. We investigated the effect of different antihypertensive treatments on circulating levels of renin-angiotensin system (RAS) components in end-stage renal disease (ESRD) patients on hemodialysis. ESRD patients were grouped following the prescribed antihypertensive drugs: ß-blocker, ß-blocker+ACEi and ß-blocker+AT R blocker. ESDR patients under no antihypertensive drug treatment were used as controls. Blood samples were collected before hemodialysis sessions. Enzymatic activities of the angiotensin-converting enzymes ACE and ACE2 were measured through fluorescence assays and plasma concentrations of the peptides Angiotensin II (Ang II) and Angiotensin-(1-7) [Ang-(1-7)] were quantified using mass spectrometry (LC-MS/MS). ACE activity was decreased only in the ß-blocker+ACEi group compared to the ß-blocker+AT R, while ACE2 activity did not change according to the antihypertensive treatment. Both Ang II and Ang-(1-7) levels also did not change according to the antihypertensive treatment. We concluded that the treatment of ESRD patients on hemodialysis with different antihypertensive drugs do not alter the circulating levels of RAS components.