Clinical Significance of Plasma Renin Activity in Human Renovascular Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 239s-242s
Author(s):  
A. Salvetti ◽  
F. Arzilli ◽  
P. Sassano ◽  
L. Poli ◽  
A. Pesola
Keyword(s):  
Plasma Renin Activity ◽  
Renovascular Hypertension ◽  
Venous Blood ◽  
Plasma Renin ◽  
Renin Secretion ◽  
Renin Activity ◽  
Diagnostic Significance ◽  
Receptor Blocking ◽  
Contralateral Kidney ◽  
Β Receptor

1. Plasma renin activity (PRA) in peripheral venous blood of patients with renovascular hypertension was found to be high (thirty-five), normal (twenty-one) and low (three). Twenty-one patients with high PRA were cured or improved after successful surgery, as were eight of eleven with normal PRA and one with a low PRA. After surgery high PRA values became normal or low. 2. A β-receptor-blocking agent (oxprenolol) decreased PRA in twenty-eight patients (responders) and it either did not modify or increased PRA in the other fifteen (non-responders). All fourteen non-responders were cured by surgery, as were thirteen out of fifteen responders; ten non-responders became responders after surgery. Oxprenolol suppressed renin secretion of both kidneys of two patients with essential hypertension, and it either decreased (six) or did not modify (four) renin secretion from the ischaemic kidney. 3. PRA measurement in renal veins of twenty-six patients with renovascular hypertension showed that only the ischaemic kidney contributes to the peripheral PRA, renin secretion being suppressed in the contralateral kidney. The suppression of renin secretion from the ischaemic kidney produced either by nephrectomy (nine) or by aortorenal by-pass (six) normalized blood pressure. 4. Peripheral PRA values are of poor diagnostic significance and PRA unresponsiveness to a β-receptor-blocking drug and the suppression of renin secretion from the ischaemic kidney are characteristic findings of renovascular hypertension curable by appropriate surgery.

Quantitative Effects of Timolol and Hydrochlorothiazide on Blood Pressure, Heart Rate and Plasma Renin Activity: Results of a Double-Blind Factorial Trial in Patients with Essential Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 517s-519s
Author(s):  
J. P. Chalmers ◽  
J. S. Horvath ◽  
P. I. Korner ◽  
D. J. Tiller ◽  
A. J. Bune ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity ◽  
Receptor Blockade ◽  
Double Blind ◽  
Receptor Blocking ◽  
Placebo Phase ◽  
Factorial Trial ◽  
Β Receptor

1. The anti-hypertensive actions of timolol and hydrochlorothiazide were analysed in a double-blind 2 × 2 factorial trial in twenty patients with essential hypertension. Each patient went through four phases of 8 weeks in randomized order, receiving timolol alone, hydrochlorothiazide alone, timolol plus hydrochlorothiazide, and placebo. 2. Supine mean arterial pressure fell from 119 mmHg in the placebo phase, to 110 mmHg during the thiazide phase, 106 mmHg during the timolol phase, and to 101 mmHg during the combined timolol plus hydrochlorothiazide phase. 3. Factorial analysis revealed that the hypotensive actions of the β-receptor-blocking drug and the diuretic were additive, without any synergism or antagonism. 4. Plasma renin activity measured in ng 3 h—1 ml—1 rose from 502 in the placebo phase to 9·54 in the diuretic phase, but fell to 1·79 in the β-receptor blockade. It was unchanged in the combined therapy phase, despite the greater drop in blood pressure. These results suggest that the fall in plasma renin activity during β-receptor blockade is of little importance in the hypotensive action of β-receptor-blocking drugs.

Fibrinolytic and Renin Activity in Renal Vein Blood of Patients with Renovascular Hypertension

1969 ◽  
Vol 21 (01) ◽  
pp. 012-019
Author(s):  
A Nowak ◽  
F Kokot ◽  
Z Czekała ◽  
J Dosiak ◽  
J Kuska
Keyword(s):  
Plasma Renin Activity ◽  
Renovascular Hypertension ◽  
Fibrinolytic Activity ◽  
Inferior Vena ◽  
Venous Blood ◽  
Vena Cava ◽  
Plasma Renin ◽  
Fibrinolytic System ◽  
Renin Activity ◽  
Hepatic Venous Blood

SummaryThe fibrinolytic system has been studied in 20 patients with renovascular hypertension.Renal and hepatic venous blood was drawn by selective cathetherisations, while peripheral blood was obtained from the inferior vena cava above the bifurcation. In all blood samples the euglobulin fibrinolysis, antiplasmin, plasminogen, fibrinogen, and plasma renin activity were determined.Samples were taken at recumbency and after tilting to 80° for 30 min. In contradistinction to plasma renin activity no differences of the fibrinolytic activity between renal and peripheral venous blood even in that obtained from ischemic kidneys were proved.No diminished secretion of plasminogen activator by ischemic kidneys in man was stated.In the light of the data obtained the participation of fibrinolytic system in the pathogenesis of renovascular hypertension is doubtfal.

Renin-aldosterone system suppression during water immersion in renovascular hypertension

1985 ◽  
Vol 68 (5) ◽  
pp. 609-612 ◽  
Author(s):  
P. Coruzzi ◽  
A. Biggi ◽  
L. Musiari ◽  
C. Ravanetti ◽  
A. Novarini
Keyword(s):  
Plasma Renin Activity ◽  
Renovascular Hypertension ◽  
Water Immersion ◽  
Distal Tubule ◽  
Plasma Renin ◽  
Sodium Concentration ◽  
Renin Secretion ◽  
Renin Activity ◽  
Reflex Control ◽  
Cardiopulmonary Receptors

1. We studied renin-aldosterone system behaviour in five renovascular hypertensive patients during central hypervolaemia by water immersion to the neck. 2. Water immersion significantly suppressed the high peripheral renin levels of the patients despite an autonomic renin secretion from the stenotic kidney, a significant reduction of mean blood pressure and an increase in distal tubule sodium concentration. 3. The effect of immersion on plasma aldosterone appeared to be primarily mediated via suppression of plasma renin activity (PRA). 4. Our data suggest that: (a) the renin secretion is mainly modulated by cardiopulmonary receptors activity; (b) the neurogenic reflex control of plasma renin activity is very effective in renovascular hypertension.

Differential maturation of beta-adrenoceptor-mediated responses in the lamb fetus

1988 ◽  
Vol 255 (5) ◽  
pp. R794-R798 ◽  
Author(s):  
N. M. Rawashdeh ◽  
J. C. Rose ◽  
N. D. Ray
Keyword(s):  
Heart Rate ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Secretion ◽  
Renin Activity ◽  
Functional Maturity ◽  
Beta Adrenoceptor ◽  
Beta Receptor

To study the functional maturity of beta-receptor-mediated responses, seven chronically catheterized lamb fetuses, 93-107 days of gestation, and seven fetuses, 116-134 days of gestation, received intravenous randomly sequenced infusions of isoproterenol (ISO) 0.03, 0.06, and 0.125 micrograms.kg-1.min-1 for 10 min separated by 45-min intervals or two saline infusions followed by 0.125 micrograms.kg-1.min-1 ISO after treatment with 0.5 mg/kg propranolol (PRO). Each fetus received the two treatments 24-48 h apart. In immature fetuses, plasma renin activity (PRA) of 2.0 +/- 0.7 ng.ml-1.h-1 did not change with either protocol. In mature fetuses, PRA of 7.5 +/- 2.5 ng.ml-1.h-1 increased two- to three-fold after the infusion of the highest two doses of ISO (P less than 0.003). Propranolol blocked this response. No significant changes were observed after the infusions of the lowest dose of ISO or saline. Both groups showed significant heart rate increases with all doses of ISO. Propranolol injection decreased heart rate significantly and blocked responses to ISO. We conclude that although a cardiac beta-receptor-mediated response is present by 93 days of gestation in the lamb fetus, a renal beta-receptor-mediated response, renin secretion, is absent.

What Stimulates the Renin—Angiotensin System in Rats with two-Kidney Renal Hypertension?

1983 ◽  
Vol 64 (5) ◽  
pp. 463-470
Author(s):  
Y. Takata ◽  
A. E. Doyle ◽  
M. Veroni ◽  
S. G. Duffy
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Renin Angiotensin System ◽  
Plasma Renin ◽  
Renin Activity ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Contralateral Kidney ◽  
The One ◽  
Renin Content

1. Blood pressure, the hypotensive effect of captopril, plasma renin activity, renal renin content and kidney weight were measured in the two-kidney—one-clip model, the one-kidney—one-clip model and the two-kidney—one-clip model with the ureter of the contralateral kidney ligated in rats. The ureteric ligation was performed to abolish urinary excretion from the contralateral kidney in the two-kidney—one-clip model. 2. The development of hypertension after renal artery constriction was earlier and greater in the one-kidney—one-clip model and the two-kidney—one-clip model with ureter of the contralateral kidney ligated than in the two-kidney—one-clip model. A single oral dose of captopril produced a greater fall in blood pressure in both the two-kidney models than in the one-kidney—one-clip group. 3. Plasma renin activity and renal renin content of the clipped kidney were higher in the two-kidney model rats, whether or not the ureter had been ligated, than in the one-kidney—one-clip model animals, although more than half the rats from the two-kidney model had normal values. There was a significant correlation between plasma renin activity and the response to captopril in all groups, whereas in none of the three groups was the correlation between plasma renin activity and blood pressure significant. 4. The clipped kidney had a higher renin content than did the contralateral kidney, and the weight of the ischaemic kidney was decreased compared with the contralateral kidney whether it was untouched or had its ureter ligated. The weight of the clipped kidney was in the order one-kidney—one-clip model > two-kidney—one-clip model with ureter of the contralateral kidney ligated > two-kidney—one-clip model. 5. It was concluded that the renin-angiotensin system was stimulated to the similar degree in some animals for the two-kidney—one-clip models, whether or not the ureter of the contralateral kidney had been ligated, compared with the one-kidney—one-clip animals. This finding suggests that the contralateral kidney can stimulate renin secretion and synthesis in the clipped kidney independently of Na+ excretion.

Effects of indomethacin in dogs with acute and chronic renovascular hypertension

1981 ◽  
Vol 240 (4) ◽  
pp. H533-H538
Author(s):  
J. R. Dietz ◽  
J. O. Davis ◽  
J. M. DeForrest ◽  
R. H. Freeman ◽  
S. F. Echtenkamp ◽  
...  
Keyword(s):  
Plasma Renin Activity ◽  
Renovascular Hypertension ◽  
Acute Phase ◽  
Renal Plasma Flow ◽  
Plasma Renin ◽  
Renin Activity ◽  
Arterial Blood ◽  
Renal Prostaglandins ◽  
High Level ◽  
Vascular Receptor

This study examines the role that prostaglandins play in both the developmental and chronic phases of renovascular hypertension. Two 5-mg/kg doses of indomethacin were given to conscious dogs with renal denervation and receiving propranolol during the acute and chronic phases of one-kidney (1-KHT) and the acute phase of two-kidney (2-KHT) renovascular hypertension. Indomethacin produced striking reductions in plasma renin activity from the high level observed during the acute phase of both 1-KHT and 2-KHT. However, plasma renin activity failed to return to normal, and the hypertensive level of pressure decreased only slightly. In the chronic 1-KHT dogs, indomethacin did not lower plasma renin activity or mean arterial blood pressure unless plasma renin activity was elevated above the normal level. Also, indomethacin failed to alter renal function during the acute phase of 1-KHT but effective renal plasma flow fell during chronic 1-KHT. These results suggest that, in the dog, renal prostaglandins are involved in the pathogenesis of both acute 1-KHT and 2-KHT, whereas the role of renal prostaglandins in the regulation of arterial pressure appears to be negligible in chronic 1-KHT except during superimposed sodium depletion or severe hypertension. The data indicate that prostaglandins are involved in renovascular hypertension in the dog only under conditions where plasma renin activity is elevated. It is suggested that the release of renin after renal artery constriction is mediated by the vascular receptor that is at least partially independent of renal prostaglandin synthesis.

Role of macula densa cyclooxygenase-2 in renovascular hypertension

2003 ◽  
Vol 284 (3) ◽  
pp. F498-F502 ◽  
Author(s):  
Andrea Hartner ◽  
Nada Cordasic ◽  
Margarete Goppelt-Struebe ◽  
Roland Veelken ◽  
Karl F. Hilgers
Keyword(s):  
Plasma Renin Activity ◽  
Renovascular Hypertension ◽  
Plasma Renin ◽  
Juxtaglomerular Apparatus ◽  
Macula Densa ◽  
Renin Activity ◽  
Disease States ◽  
Renin Synthesis ◽  
Cox 2

Upregulation of the inducible cyclooxygenase (COX-2) in the macula densa accompanies the activation of the juxtaglomerular apparatus in many high-renin conditions. The functional role of COX-2 in these disease states is poorly understood. We tested whether COX-2 is required to increase renin in renovascular hypertension. Rats with established two-kidney, one-clip (2K1C) hypertension were treated for 2 wk with two different inhibitors of COX-2, NS-398 and rofecoxib, respectively. Hypertension in 2K1C rats was not affected or slightly enhanced by COX-2 inhibition, as measured intra-arterially in conscious animals. The increase in plasma renin activity was also unchanged by both rofecoxib and NS-398. The number of glomeruli with a renin-positive juxtaglomerular apparatus was elevated in clipped kidneys and decreased in contralateral kidneys of 2K1C rats. This pattern was unaltered by COX-2 inhibition. To test the effects of COX-2 blockade on a primarily macula densa-mediated stimulus, we studied salt depletion for comparison. A low-salt diet induced a significant increase in plasma renin activity, which was partially inhibited by treatment with NS-398. We conclude that inhibition of COX-2 in established renovascular hypertension does not affect renin synthesis or release. Thus either COX-2 is not necessary for the macula densa mechanism or the macula densa is not important for maintaining high renin in renovascular hypertension.

Micro determination of plasma renin activity in normal infants and children on capillary and venous blood

1979 ◽  
Vol 99 (1) ◽  
pp. 93-95 ◽  
Author(s):  
Michéle Dechaux ◽  
Jean-Marie Limal ◽  
Michel Broyer ◽  
Charles Sachs
Keyword(s):  
Plasma Renin Activity ◽  
Venous Blood ◽  
Plasma Renin ◽  
Infants And Children ◽  
Renin Activity
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