scholarly journals The circulating renin-angiotensin-aldosterone system is down-regulated in dogs with glomerular diseases compared to other chronic kidney diseases with low-grade proteinuria

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262121
Author(s):  
Lisa-Maria Grandt ◽  
Ariane Schweighauser ◽  
Alan Kovacevic ◽  
Thierry Francey
Keyword(s):  
Kidney Diseases ◽  
Plasma Renin ◽  
Fractional Excretion ◽  
Fluid Volume ◽  
Volume Status ◽  
Low Grade ◽  
Glomerular Diseases ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Fractional Excretion Of Sodium

Glomerular diseases (GD) lead to a variety of disorders of the vascular and the total body water volumes. Various pathomechanisms, including vascular underfill and overfill, have been suggested to explain these disturbances. Accordingly, the circulating renin-angiotensin-aldosterone system (cRAAS) is expected to be activated as either a cause or a result of these fluid disorders. The aim of this study was to characterize the activity of the cRAAS in dogs with GD and to evaluate its relationship with the vascular volume status. In a prospective study, we evaluated the plasma renin activity and the serum aldosterone concentration in 15 dogs with GD. Their fluid volume status was estimated with clinical variables reflecting volemia and hydration, echocardiographic volume assessment, N-terminal pro B-type natriuretic peptide, blood urea nitrogen:creatinine ratio, and the urinary fractional excretion of sodium. Ten dogs with chronic kidney disease (CKD) with matching degree of azotemia were recruited as controls. The activity of the cRAAS was low in 10 dogs, normal in 3 dogs, high in 1 dog and equivocal (high renin—low aldosterone) in 1 dog with GD. These dogs had a lower cRAAS activity than dogs with CKD (p = 0.01). The clinical evaluation showed 8 hypovolemic and 7 non-hypovolemic dogs; 3 dehydrated, 9 euhydrated and 3 overhydrated dogs. The cRAAS activity was not different between hypovolemic and non-hypovolemic dogs. The down-regulated cRAAS without obvious association with the clinical volume status of these dogs with GD, suggests different mechanisms of fluid volume dysregulation in dogs with GD than previously assumed. This finding however should be confirmed in a focused larger scale study, as it may influence the use of cRAAS blockers as part of the standard therapy of GD in dogs.

scholarly journals Diabetes and Renin-Angiotensin-Aldosterone System: Pathophysiology and Genetics

2021 ◽  
Author(s):  
A.H.M. Nurun Nabi ◽  
Akio Ebihara
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Diseases ◽  
Kidney Diseases ◽  
Association Studies ◽  
Plasma Renin ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Genome Wide ◽  
Renal Vascular

Diabetes mellitus (DM) is a metabolic disorder and characterized by hyperglycemia. Being a concern of both the developed and developing world, diabetes is a global health burden and is a major cause of mortality world-wide. The most common is the type 2 diabetes mellitus (T2DM), which is mainly caused by resistance to insulin. Long-term complications of diabetes cause microvascular related problems (eg. nephropathy, neuropathy and retinopathy) along with macrovascular complications (eg. cardiovascular diseases, ischemic heart disease, peripheral vascular disease). Renin-angiotensin-aldosterone system (RAAS) regulates homeostasis of body fluid that in turn, maintains blood pressure. Thus, RAAS plays pivotal role in the pathogenesis of long-term DM complications like cardiovascular diseases and chronic kidney diseases. T2DM is a polygenic disease, and the roles of RAAS components in insulin signaling pathway and insulin resistance have been well documented. Hyperglycemia has been found to be associated with the increased plasma renin activity, arterial pressure and renal vascular resistance. Several studies have reported involvement of single variants within particular genes in initiation and development of T2D using different approaches. This chapter aims to investigate and discuss potential genetic polymorphisms underlying T2D identified through candidate gene studies, genetic linkage studies, genome wide association studies.

Effect of intrarenal renin inhibition on renal hemodynamics and excretory function

1990 ◽  
Vol 259 (1) ◽  
pp. R7-R14 ◽  
Author(s):  
K. M. Verburg ◽  
J. R. Kadam ◽  
G. A. Young ◽  
S. H. Rosenberg ◽  
H. D. Kleinert
Keyword(s):  
Recovery Period ◽  
Renin Angiotensin System ◽  
Plasma Renin ◽  
Fractional Excretion ◽  
Urine Flow ◽  
Electrolyte Excretion ◽  
Angiotensin System ◽  
Excretory Function ◽  
Fractional Excretion Of Sodium ◽  
Renin Inhibition

This study was designed to investigate in sodium-depleted monkeys the renal hemodynamic and excretory effects resulting from blockade of the renin-angiotensin system induced by intrarenal infusion of the primate-selective renin inhibitor A-65317. Intrarenal infusion of A-65317 (n = 6) at a dose of 0.01 micrograms.kg-1.min-1 elicited an increase (P less than 0.05) in renal blood flow (RBF) from 43.5 +/- 2.7 to 49.4 +/- 4.4 ml/min and glomerular filtration rate (GFR) from 6.3 +/- 0.3 to 6.9 +/- 0.4 ml/min, with no significant changes in mean arterial pressure (MAP) or plasma renin activity (PRA). Increases (P less than 0.05) in the urine flow rate (0.18 +/- 0.04 to 0.28 +/- 0.04 ml/min) and the fractional excretion of sodium (0.18 +/- 0.06 to 0.35 +/- 0.13%) were also observed. After a recovery period, the intrarenal infusion dose of A-65317 was increased to 0.1 microgram.kg-1.min-1 and RBF increased (P less than 0.05) from 42.9 +/- 3.9 to 53.0 +/- 3.7 ml/min in conjunction with a significant 85 +/- 4% inhibition of PRA and a 14 +/- 4 mmHg reduction in MAP. GFR and electrolyte excretion remained at control levels. Intrarenal infusion of vehicle (n = 6) had no significant effect on any of the variables studied. In a separate group of monkeys, intravenous (iv) infusion of A-65317 at 0.01 microgram.kg-1.min-1 (n = 5) did not result in significant changes from control.(ABSTRACT TRUNCATED AT 250 WORDS)

Independence of salt intake induced by calcium deprivation from the renin-angiotensin-aldosterone system

1993 ◽  
Vol 264 (3) ◽  
pp. R492-R499 ◽  
Author(s):  
M. G. Tordoff ◽  
D. M. Pilchak ◽  
R. L. Hughes
Keyword(s):  
Salt Intake ◽  
Plasma Renin ◽  
Calcium Deficiency ◽  
Plasma Aldosterone ◽  
Sodium Balance ◽  
Plasma Sodium ◽  
Receptor Blockade ◽  
Renin Angiotensin Aldosterone System ◽  
Angiotensin System ◽  
Renin Angiotensin

We investigated whether the elevated NaCl intake shown by calcium-deprived rats is mediated by the renin-angiotensin-aldosterone system. First, we looked for manifestations of altered renin-angiotensin-aldosterone system activity during the progression of calcium deficiency. There were no differences between control and calcium-deprived rats in plasma aldosterone concentrations, plasma renin activity, plasma sodium concentrations, sodium balance, or blood pressure. Second, we used selective pharmacological antagonists to examine whether disruption of the renin-aldosterone-angiotensin system influenced salt intake. Blockade of aldosterone receptors with spironolactone (25 mg.kg-1 x day-1 sc for 7 days) had no effect on NaCl intake of control or calcium-deprived rats. Angiotensin AT1 receptor blockade with losartan potassium (0.5-10 mg/kg orally) had no effect on NaCl intake of control or calcium-deprived rats but doses > 0.5 mg/kg decreased NaCl intake of adrenalectomized rats. Taken together, these findings indicate that the renin-angiotensin-aldosterone system does not mediate the increased NaCl intake produced by calcium deficiency. The appetite for salt produced by calcium deficiency involves a different physiological substrate from most other models of NaCl intake.

scholarly journals Effect of renal denervation on catecholamines and the renin–angiotensin–aldosterone system

2020 ◽  
Vol 21 (3) ◽  
pp. 147032032094309
Author(s):  
Lida Feyz ◽  
Sjoerd van den Berg ◽  
Robert Zietse ◽  
Isabella Kardys ◽  
Jorie Versmissen ◽  
...  
Keyword(s):  
Plasma Renin ◽  
Drug Regimen ◽  
Plasma Aldosterone ◽  
Renal Sympathetic Denervation ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Post Procedure ◽  
Endogenous Catecholamines ◽  
Significant Change ◽  
Renal Sympathetic

Introduction: The effect of renal sympathetic denervation (RDN) on neurohormonal responses is largely unknown. We aimed to assess the effect of RDN on the renin–angiotensin–aldosterone system (RAAS) and endogenous catecholamines. Methods: A total of 60 patients with hypertension underwent RDN and remained on a stable antihypertensive drug regimen. Samples for plasma aldosterone, plasma renin and urine (nor)metanephrine were collected at baseline and at 6 months post procedure. Ambulatory blood pressure (BP) recordings were obtained at baseline and at 6 months post procedure. Results: Mean age was 64±9 years, and 30/60 patients were male. At 6 months, average daytime systolic and diastolic ambulatory BP decreased by 10 and 6 mmHg, respectively ( p<0.001). No significant change was observed in plasma aldosterone (median=248.0 pmol/L (interquartile range (IQR) 113.3–369.5 pmol/L) vs. median=233.0 pmol/L (IQR 110.3–360.8 pmol/L); p=0.66); renin (median=19.5 µIU/mL (IQR 6.8–119.5 µIU/mL) vs. median=14.3 µIU/mL (IQR 7.2–58.0 µIU/mL); p=0.32), urine metanephrine (median=0.46 µmol/L (IQR 0.24–0.77 µmol/L) vs. median=0.46 µmol/L (IQR 0.22–0.88 µmol/L); p=0.75) and normetanephrine (median=1.41 µmol/L (IQR 0.93–2.00 µmol/L vs. median =1.56 (IQR 0.74–2.50 µmol/L); p=0.58) between baseline and 6 months, respectively. No correlation was found between the decrease in mean systolic daytime BP and changes in RAAS hormones or endogenous catecholamines. Conclusion: Despite significant reductions in ambulatory BP, RDN did not result in a significant change in endogenous catecholamines or in RAAS hormones at 6 months.

Acromegaly and hypertension: role of the renin-angiotensin-aldosterone system

1982 ◽  
Vol 100 (4) ◽  
pp. 581-587 ◽  
Author(s):  
Bengt E. Karlberg ◽  
Anna-Maria Ottosson
Keyword(s):  
Blood Pressure ◽  
High Frequency ◽  
Plasma Renin ◽  
Plasma Aldosterone ◽  
Substantial Part ◽  
Volume Factor ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Before And After

Abstract. The incidence of arterial hypertension was evaluated in a partly retrospective study of patients with active acromegaly. Of 37 patients studied, 18 (48%) had hypertension, i.e. a supine blood pressure of > 160/95 mmHg. The type of hypertension was explored further by measuring plasma renin activity and, in some patients plasma aldosterone concentrations before and after stimulation (upright posture or furosemide 80 mg given orally). Urinary 24 h excretion of aldosterone was also determined. About half of the patients with hypertension but also a substantial part of normotensive acromegalics had inappropriately low plasma renin levels both during basal conditions and after stimulation. On the other hand urinary aldosterone excretion was either normal or (in 2 patients) slightly elevated. There was no other evidence of coexistent primary aldosteronism. Our results confirm previous reports of a high frequency of alterations in the renin-angiotensin-aldosterone system in acromegalic patients with growth hormone excess which in some instances may lead to an elevated blood pressure. The biochemical changes have many similarities to low renin essential hypertension. A volume factor may be operating in acromegalic patients with hypertension since in 10 patients treatment with the aldosterone antagonist, spironolactone, with doses between 50–200 mg daily lowered blood pressure to near normal levels. Thus, spironolactone seems to be a worthwhile alternative in the treatment of hypertensive acromegalics.

scholarly journals The Influence of Long Term Hydrochlorothiazide Administration on the Relationship between Renin-Angiotensin-Aldosterone System Activity and Plasma Glucose in Patients with Hypertension

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Xu Xiao ◽  
Hong-jun Du ◽  
Wei-jian Hu ◽  
Peter X. Shaw
Keyword(s):  
Plasma Glucose ◽  
Density Lipoprotein ◽  
Plasma Renin ◽  
Ang Ii ◽  
Elevated Plasma ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Glucose Levels ◽  
One Year ◽  
The Relationship

Objective. To observe the relationship between changes in renin-angiotensin-aldosterone system (RAAS) activity and blood plasma glucose after administration of hydrochlorothiazide (HCTZ) for one year in patients with hypertension.Methods. 108 hypertensive patients were given 12.5 mg HCTZ per day for one year. RAAS activity, plasma glucose levels, and other biochemical parameters, as well as plasma oxidized low density lipoprotein (oxLDL) levels, were measured and analyzed at baseline, six weeks, and one year after treatment.Results. After one year of treatment, the reduction in plasma glucose observed between the elevated plasma renin activity (PRA) group (-0.26±0.26 mmol/L) and the nonelevated PRA group (-1.36±0.23 mmol/L) was statistically significant (P<0.05). The decrease of plasma glucose in the elevated Ang II group (-0.17±0.18 mmol/L) compared to the nonelevated Ang II group (-1.07±0.21 mmol/L) was statistically significant (P<0.05). The proportion of patients with elevated plasma glucose in the elevated Ang II group (40.5%) was significantly higher than those in the nonelevated Ang II group (16.3%) (P<0.05). The relative oxLDL level was not affected by the treatment.Conclusions. Changes in RAAS activity were correlated with changes in plasma glucose levels after one year of HCTZ therapy.

Inhibition of the Renin-Angiotensin-Aldosterone System by l-Dopa with and without Inhibition of Extracerebral Dopa Decarboxylase in Man

1981 ◽  
Vol 61 (2) ◽  
pp. 187-190 ◽  
Author(s):  
C. Barbieri ◽  
R. Caldara ◽  
C. Ferrari ◽  
Rosa Maria Crossignani ◽  
M. Recchia
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Plasma Renin ◽  
Normal Subjects ◽  
Plasma Aldosterone ◽  
Renin Angiotensin Aldosterone System ◽  
Plasma Aldosterone Concentration ◽  
Renin Angiotensin ◽  
Drugs Analysis ◽  
Catecholamine Levels

1. The present study was undertaken to investigate the possibility that central nervous system mono-aminergic pathways may play a role in the control of the renin-angiotensin-aldosterone system in man. 2. Eight normal subjects received in a randomized order placebo, l-dopa (500 mg, orally) and l-dopa (100 mg, orally) plus carbidopa (35 mg, orally) after pretreatment with carbidopa (50 mg every 6 h for four doses). 3. l-Dopa administration elicited a significant fall in plasma renin activity (PRA) (P < 0.01 at 120, 150 and 180 min) and in plasma aldosterone levels (P < 0.05 at 90, 120, 150 and 180 min); L-dopa plus carbidopa induced a decrease in PRA (P < 0.05 at 120 and 150 min, P < 0.01 at 180 min) and in plasma aldosterone concentration (P < 0.05 at 30 and 60 min, P < 0.01 at 90 and 120 min), in comparison with placebo administration; between-drugs analysis revealed no difference in the decreases in PRA and plasma aldosterone levels induced by the two regimens. 4. Since l-dopa, as well as l-dopa plus carbidopa, has been shown to augment catecholamine levels in the brain of various animal species, the present data suggest that in man PRA and plasma aldosterone concentration might be inhibited by increased central nervous system catecholamine levels.

scholarly journals Inferior Vena Cava Collapsibility Index: A Precise Non-invasive Tool for Evaluation of Edema in Children with Nephrotic Syndrome.

2021 ◽  
Author(s):  
Hanan El-Halaby ◽  
Ashraf Bakr ◽  
Mohamed El-Assmy ◽  
Hussein Abdelaziz Abdalla ◽  
Marwa Salem ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Fractional Excretion ◽  
Volume Status ◽  
Non Invasive ◽  
Collapsibility Index ◽  
Fractional Excretion Of Sodium ◽  
Status Assessment

Abstract Evaluating the volume status in children with Idiopathic nephrotic syndrome (INS) is mandatory to guide treatment and avoid unnecessary possibly hazardous albumin use. This study aimed to evaluate and compare the available tools used for volume status assessment and differentiating type of edema in children with INS. Sixty children with active INS were included and subdivided into hypovolemic and non-hypovolemic groups based on fractional excretion of sodium (FeNa%) and clinical assessment. All patients were studied for Inferior vena cava collapsibility index (IVCCI), plasma atrial natriuretic peptide (ANP) concentration and Body composition monitor (BCM). Forty-four patients (77.3%) had non-hypovolemic and 16 (26.7%) had hypovolemic states. Plasma ANP levels didn’t differ between hypovolemic and non-hypovolemic subgroups. IVCCI was higher in hypovolemic group (p<0.001) with sensitivity 87.5% and specificity 81.8% for hypovolemia detection while BCM-over hydration (BCM-OH) values were higher in non-hypovolemic group (p=0.04) with sensitivity= 68.2% and specificity =75% for detection of hypervolemia. FeNa% showed negative significant correlation with IVCCI (r= -0.578, p <0.001) and positive significant correlation with BCM-OH (r= 0.33, p=0.018), while FeNa% showed non-significant correlation to plasma ANP concentration (p=0.25). Conclusion: Non-hypovolemic edema is more frequent in edematous INS children than hypovolemic states. IVCCI is a reliable non-invasive bedside tool for evaluating volume status in INS children and is superior to BCM while plasma ANP levels can’t discriminate type of edema in INS.

scholarly journals RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM IN PATIENTS WITH ABDOMINAL OBESITY AND ARTERIAL HYPERTENSION

2013 ◽  
Vol 19 (5) ◽  
pp. 389-396 ◽  
Author(s):  
E. A. Bazhenova ◽  
O. D. Belyaeva ◽  
A. V. Berezina ◽  
T. L. Karonova ◽  
D. A. Kolodina ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin ◽  
Plasma Aldosterone ◽  
Obese Patients ◽  
Renin Angiotensin Aldosterone System ◽  
Plasma Aldosterone Concentration ◽  
Renin Angiotensin ◽  
Primary Disorder ◽  
Per Se ◽  
Design And Methods

Objective. The activity of renin-angiotensin-aldosterone system (RAAS) is increased in patients with ab-dominal obesity (AO). However, till present time it is unclear whether RAAS activation or hypertension (HTN) found in 50 % patients is the primary disorder.Design and methods. We have studied plasma renin activity (PRA), plasma aldosterone concentration (PAC), their ratio PAC/PRA in patients with AO and related HTN and in subjects without AO.Results. PRA was higher in patients with AO versus people without obesity (2,5 ± 0,2 and 1,7 ± 0,7 ng/ml/hr, p = 0,013), there was a tendency to the reduction of the ratio PAC/PRA in obese patients (14,6 ± 0,9 and 19,7 ± 3,3, p = 0,08). In the subgroup of patients with AO and HTN the PRA was higher, and the ratio PAC/PRA was lower than in obese patients without HTN (PRA: 3,3 ± 0,4 and 1,7±0,2 ng/ml/hr, p = 0,005; PAC/PRA: 11,4 ± 1,1 and 17,4 ± 1,4, p < 0,0001). PRA and systolic blood pressure positively correlated. In patients with morbid obesity (3 degree according to the WHO classiication) obesity may play a signiicant role in the increase of RAAS activity, especially in the absence of concomitant HTN. The ratio PAC/PRA in over weight patients with AO was higher than in patients with AO and body mass index ? 30,0 kg/m (17,2 ± 1,7 and 12,5 ± 1,0 kg/m, p = 0,04). PRA was higher only in patients with AO and co-existing hypertension (3,4 ± 0,7 and 1,1 ± 0,2 ng/ml/hr, p = 0,04).Conclusions. RAAS activity is increased in patients with AO, also due to the co-existing HTN. However, in the absence of elevated blood pressure obesity per se may play a signiicant role in RAAS hyperactivity.

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