Renin-Angiotensin-Albosterone System in Chronic Renal Failure:Part 1) Relation between hypertension and the renin-angiotensin-aldosterone system in chronic renal failure
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Plasma renin activity (PRA), plasma angiotensin II in arterial blood (PAL) and plasma aldosterone (Paid) were measured by radioimmunoassay in 106 cases of chronic renal failure including 14 of malignant hypertension. PRA, PAL and Paid were 0.80±1.11 (normal 1.17±0.90) ng/ml/h, 48.2±38.8 (normal 53.2±29.3) pg/ml and 10.4±16.3 (normal 7.3±3.5)ng/100ml, respectively, in chronic renal failure. In malignant hypertension, these showed high levels of 3.15±2.81ng/ml/h, 146.8±99.2pg/ml and 36.0±26.8ng/100ml, respectively. PRA and PAL showed slightly low levels in mild forms of chronic renal failure (blood urea nitrogen : below 30 mg/100ml) both with and without hypertension, and high levels accompanied with an elevated serum potassium in severe forms with hypertension. On the other hand, very low levels were found in severe forms of this syndrome without hypertension. In hypertensive patients with chronic renal failure there was a positive correlation between the renin-angiotensin system and the aldosterone level. Paid however was relatively high in relation to PRA and PAL. The present data indicate that in terminal stage kidney disease plasma aldosterone is largely controlled by the corresponding adrenotrophic actions of the renin-angiotensin system and the level of potassiun. In such cases the former remains the primary factor despite severe renal parenchymal damage. It is also postulated that possible factors contributing to this syndrome are structural or functional changes of the juxtaglomerular apparatus secondary to renal disease and altered adrenal function. The abnormality in renin-angiotensin might well contribute to the hypertension in certain types of the severe form of this disease.
- 社団法人 日本腎臓学会の論文
社団法人 日本腎臓学会 | 論文
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