INVOLVEMENT OF THE RENIN-ANGIOTENSIN SYSTEM IN THE PATHOGENESIS OF POSTEXERCISE PROTEINURIA

Proteinuria after strenuous exercise is common in healthy subjects. Th e pathophysiologic mechanism of postexercise proteinuria (PEP) is not clear, although the phenomenon has long been known and many explanator y theories have been proposed. It is widely recognized that angiotensi n II may increase filtration of protein through the glomerular membran e, and that its concentration in plasma increases during exercise. The aim of this study was to evaluate possible involvement of angiotensin II in the pathogenesis of PEP. Of 25 young volunteers who performed m aximal aerobic exercise, eight showed PEP. The exercise was repeated a fter an interval of at least one week, now 90 minutes after administra tion of captopril (25 mg). Captopril did not affect the achieved work load of the maximal blood pressure and heart rate during the exercise, but PEP was not found. As it was possible to prevent PEP by administe ring an angiotensin-converting enzyme inhibitor, the study supports th e theory that the renin angiotensin system is involved in the pathogen esis of PEP.