LAUSR

The role of the renin-angiotensin-aldosterone system (RAAS) and its components in the pathogenesis of diabetic nephropathy has been the subject of many studies for years. The importance of angiotensin, but also angiotensin-converting enzyme (ACE) and angiotensin II type 1 receptor (AT1R) is emphasized. What is more, the occurrence of anti-AT1R antibodies is associated with an increased risk of an immunologic rejection after an organ transplantation. The aim of the study was to determine the concentration of these antibodies in the group of patients with diabetic nephropathy and in the group of patients with diabetic nephropathy and after kidney transplantation. The study group consisted of 232 patients who were divided into the following subgroups: patients with diabetic nephropathy (N = 85), patients with diabetic nephropathy and after kidney transplantation (N = 97), control group (N = 50). Antibodies against AT1R were determined in the serum of all patients using ELISA. The results >17 U/mL were considered positive. The statistical analysis of the obtained results was performed using the STATISTICA 13.3 package. The Kruskal-Wallis H test was used to determine significant differences between the studied subgroups. Although differences in anti-AT1R antibodies serum concentrations of the studied subgroups could not be demonstrated, the obtained result was on the borderline of statistical significance (P = 0.068). Interestingly, the median of patients with diabetic nephropathy and after kidney transplantation was lower compared to the median of patients with diabetic nephropathy and patients from the control group (10.40 U/mL vs. 11.24 U/mL; 10.40 U/mL vs. 11.64 U/mL). 15.05% of patients after kidney transplantation were anti-AT1R antibodies-positive. In the group of patients with diabetic nephropathy this percentage was 20.00%, and in the control group 19.57%. In the group of patients with diabetic nephropathy ad after transplantation the percentage of anti-AT1R antibodies-positive is low and comparable to the control group. The presence of anti-AT1R antibodies is associated with an increased risk of kidney transplant rejection, therefore more attention should be paid to the presence of these antibodies not only in patients after kidney transplantation, but also in patients preparing for it. In order to increase the effectiveness of renal replacement therapy, continuous monitoring of patients who have anti-AT1R antibodies before transplantation is desirable.