scholarly journals How to potentialize the effect of renin-angiotensin-aldosterone system inhibitors?

KIDNEYS ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 156-161
Author(s):  
D.D. Ivanov
Keyword(s):  
Current Trend ◽  
Renin Angiotensin System ◽  
Significant Loss ◽  
Scientific Review ◽  
Renin Angiotensin Aldosterone System ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Excretory Function ◽  
Ckd Stage ◽  
Lespedeza Capitata

The scientific review presents a practical analysis of the properties of Lespedeza capitata in terms of its attractiveness for nephrological practice. Lespedeza shows many effects on ectoderm derivatives, including skin and the kidneys. Thus, the results of studies showed significant stimulation of the growth of fibroblasts and keratinocytes, as well as increased collagen synthesis with a lipolytic effect on adipocytes. The researchers concluded the possibility of using herbal medicinal preparations of Lespedeza capitata to stimulate skin cells and tissue regeneration, for anti-aging therapy and induction of lipolysis due to flavonoid extract. Lespedeza capitata extract enhances diuresis, eliminates edema, reduces azotaemia and albuminuria, increases sodium excretion, and to lesser extent potassium, promotes renal filtration and excretion of nitrogenous products in the urine. The advantages of phytotherapy in normalizing the capillary permeability of the glomeruli are a mild diuretic effect, which prevents a significant loss of electrolytes in contrast to synthetic diuretics. These effects are now considered as potentiating the action of inhibitors of the renin-angiotensin system, which is the basis of renoprotection in modern nephrology. Lespedeza flavonoids improve protein-energy metabolism, which has been demonstrated in many models of acute renal failure. Correction of protein metabolism has a favourable nephroprotective effect and slows the progression of chronic kidney disease (CKD) while maintaining normal excretory function. Lespedeza extract can be considered as a substance that enhances the action of renin-angiotensin-aldosterone system inhibitors (RAASi), acting synergistically in inhibiting the activity of the renin-angiotensin system. This property of the drug becomes very relevant in patients with CKD stage 5 when the abolition of RAASi today corresponds to the current trend. Maintaining a small dose of RAASi in stage 10 CKD, or the use of RAASi with extrarenal elimination in combination with Lespedeza extract demonstrates encouraging results in clinical practice.

scholarly journals Renin-angiotensin system in the regulation of renal excretory function in case of experimental diabetes mellitus

2021 ◽  
Vol 16 (8) ◽  
pp. 636-642
Author(s):  
О.А. Olenovych
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Experimental Diabetes ◽  
Renin Angiotensin System ◽  
Experimental Diabetes Mellitus ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Excretory Function ◽  
Pharmacological Blockade

Background. The purpose of the study was to explore the role of the renin-angiotensin system in the disturbance of renal excretory function in the dynamics of alloxan-induced experimental diabetes mellitus. Materials and methods. The experiments were carried out on 78 white non-linear mature male rats with 11-, 26- and 46-day long experimental diabetes mellitus caused by intraperitoneal administration of alloxan (160 mg/kg), against the background of pharmacological blockade of intrarenal renin-angiotensin system, induced by intraperitoneal administration of сaptopril (10 mg/kg). The study of excretory function of the kidneys was provided by the clearance method under the condition of induced water 2-hour diuresis to determine the clearance of endogenous creatinine, glomerular filtration rate, relative water reabsorption, protein content in urine, its excretion. Results. Analysis of changes in renal function after pharmacological blockade of the renin-angiotensin system in rats on day 11 of alloxan diabetes showed a significant increase in diuresis, glomerular filtration rate, endogenous creatinine concentration index, and protein excretion. The pharmacological blockade of the renin-angiotensin system had practically no effect on the intensity of the relative reabsorption of water in alloxan-diabetic rats. On day 26 of alloxan diabetes after captopril administration, there was a slight decrease in final urine volume, glomerular filtration rate, relative water reabsorption, and endogenous creatinine concentration index. At the same time, captopril did not cause an antiproteinuric effect, and protein excretion even demonstrated a tendency to increase. On day 46 of alloxan-induced diabetes after administration of captopril, there was a significant reduction in diuresis, endogenous creatinine clearance and glomerular filtration rate of rats, as well as in urinary protein concentration and excretion. Conclusions. The results of the study allow us to conclude that the initial stage of renal disorders formation in alloxan-induced experimental diabetes is associated with hemodynamic-hyperperfusion nature of renal functioning with preserved renal functional reserve and the structure of the glomerular-tubular apparatus of the kidney, autoregulatory mechanisms. Mentioned compensatory-functional changes in renal function are gradually complicated by an exhaustion of renal functional reserve and pathological activation of intrarenal renin-angiotensin system with subsequent progression of hyperperfusion-ischemic kidney damage, a decrease in the number of functioning nephrons.

scholarly journals Regression of cardiac hypertrophy in the SHR by combined renin-angiotensin system blockade and dietary sodium restriction

2001 ◽  
Vol 2 (1_suppl) ◽  
pp. S148-S153
Author(s):  
Emad Abro ◽  
Cory D Griffiths ◽  
Trefor O Morgan ◽  
Lea MD Delbridge
Keyword(s):  
Cardiac Hypertrophy ◽  
Spontaneously Hypertensive Rat ◽  
Sodium Intake ◽  
Renin Angiotensin System ◽  
Dietary Sodium ◽  
Angiotensin Ii Receptor Blocker ◽  
Renin Angiotensin Aldosterone System ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Regression Of Cardiac Hypertrophy

Altered operation of the renin-angiotensin-aldosterone system (RAAS) and dietary sodium intake have been identified as independent risk factors for cardiac hypertrophy. The way in which sodium intake and the operation of the renin-angiotensin-aldosterone system interact in the pathogenesis of cardiac hypertrophy is poorly understood. The aims of this study were to investigate the cardiac effects of the renin-angiotensin system (RAS) blockade in the spontaneously hypertensive rat (SHR), using co-treatment with an angiotensin II receptor blocker (ARB) and an angiotensin-converting enzyme (ACE) inhibitor with different sodium intakes. Our experiments with SHR show that, at high levels of sodium intake (4.0%), aggressive RAS blockade treatment with candesartan (3 mg/kg) and perindopril (6 mg/kg) does not result in regression of cardiac hypertrophy. In contrast, RAS blockade coupled with reduced sodium diet (0.2%) significantly regresses cardiac hypertrophy, impairs animal growth and is associated with elevated plasma renin and dramatically suppressed plasma angiotensinogen levels. Histological analyses indicate that the differential effect of reduced sodium on heart growth during RAS blockade is not associated with any change in myocardial interstitial collagen, but reflects modification of cellular geometry. Dimensional measurements of enzymatically-isolated ventricular myocytes show that, in the RAS blocked, reduced sodium group, myocyte length and width were decreased by about 16—19% compared with myocytes from the high sodium treatment group. Our findings highlight the importance of `titrating' sodium intake with combined RAS blockade in the clinical setting to optimise therapeutic benefit.

scholarly journals Effects of dapagliflozin on renin-angiotensin-aldosterone system under renin-angiotensin system inhibitor administration

2020 ◽  
Vol 67 (11) ◽  
pp. 1127-1138
Author(s):  
Masashi Isshiki ◽  
Ichiro Sakuma ◽  
Yasuaki Hayashino ◽  
Takashi Sumita ◽  
Kazuo Hara ◽  
...  
Keyword(s):  
Renin Angiotensin System ◽  
Renin Angiotensin Aldosterone System ◽  
Angiotensin System ◽  
Renin Angiotensin

scholarly journals Angiotensin 1-7: A Second Window of Protection in Hypertensive Patients

2019 ◽  
pp. 1-7
Author(s):  
Mazin Salaheldin Abdalla Mohamed ◽  
Muntaser Ibrahim ◽  
Muhanad S. Abdelwhab
Keyword(s):  
Human Body ◽  
Renin Angiotensin System ◽  
Cardiovascular Disorders ◽  
Protective Effects ◽  
Renin Angiotensin Aldosterone System ◽  
Angiotensin System ◽  
Hypertensive Patients ◽  
Renin Angiotensin ◽  
Second Window Of Protection

The effects of the renin-angiotensin-aldosterone system on the human body are so diverse and our knowledge about them is ever growing. Angiotensin 1-7 has been proven to play protective roles in patients with cardiovascular disorders including but not limited to hypertension. As is the case with Africa, the prevalence of hypertension in Sudan is rising, and its complications could be delayed by pharmacologically manipulating the levels of renin-angiotensin system metabolites. The aim of this review is to compare the advantageous and deleterious effects of Angiotensin 2 in contrast to those of Angiotensin 1-7 and to assert the well-established protective effects of Angiotensin 1-7 (systemically and locally) in hypertensive patients

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