Elevated urinary podocyte-derived extracellular microvesicles in renovascular hypertensive patients

Soon Hyo Kwon, John R. Woollard, Ahmed Saad, Vesna D. Garovic, Ladan Zand, Kyra L. Jordan, Stephen C. Textor, Lilach O. Lerman

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Background: An increased number of podocyte-derived extracellular vesicles (pEVs) may reflect podocyte injury in renal disease. Elevated glomerular pressure and other insults may injure podocytes, yet it remains unclear whether the numbers of pEVs are altered in hypertensive patients. We tested the hypothesis that urinary pEV levels would be elevated in patients with renovascular hypertension (RVH) compared with essential hypertension (EH) or healthy volunteers (HVs). Methods: We prospectively enrolled patients with EH (n = 30) or RVH (n = 31) to study renal blood flow (RBF) and cortical perfusion using multidetector computed tomography under controlled condition (regulated sodium intake and renin- angiotensin blockade). After isolation fromurine samples, pEVs (nephrin and podocalyxin positive) were characterized by flow cytometry. Fourteen RVH patients were studied again 3 months after stenting or continued medical therapy. HVs (n = 15) served as controls. Results: The fraction of pEV among urinary EVs was elevated in RVH compared with HVs and EH (11.46 6.4, 6.8 6 3.4 and 6.3 6 3.7%, respectively; P 0.001) and remained unchanged after 3 additional months of therapy and after controlling for clinical parameters. However, eGFR- and age-adjusted pEV levels did not correlate with any clinical or renal parameters. Conclusions: In hypertensive patients under controlled conditions, urinary pEV levels are elevated in patients with RVH and low eGFR compared with patients with EH and relatively preserved renal function. These pEVs may reflect podocyte injury secondary to kidney damage, and their levels might represent a novel therapeutic target.

Original languageEnglish (US)
Pages (from-to)800-807
Number of pages8
JournalNephrology Dialysis Transplantation
Issue number5
StatePublished - May 1 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author 2016.


  • CKD
  • extracellular vesicles
  • hypertension
  • podocyte
  • renovascular hypertension


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