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      The Renin-Angiotensin-Aldosterone System in Patients with Nephrotic Syndrome:

      , ,

      Nephron

      S. Karger AG

      Nephrotic syndrome, Renal function, Renin, Aldosterone, Saralasin

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          Abstract

          The angiotensin II analogue 1-sar-8-ala-angiotensin II (saralasin) was infused i. v. into 6 patients with stable nephrotic syndrome on a 110–120 mEq/day sodium intake. After two 60-min control periods (C<sup>+</sup>) saralasin was infused during two 30-min periods at a rate of 2 and 5 µg/kg/min, respectively, followed by 10 µg/kg/min for an additional 60 min and a subsequent control period of 60 min. Saralasin increased arterial blood pressure in a dose-dependent fashion from a mean of 126/88 (C<sup>+</sup>) to 145/109 mm Hg (10 µg/kg/min), while glomerular filtration rate fell from a mean of 145 ± 17 (C<sup>+</sup>) to 118 ± 21 ml/min (10 µg/kg/min). Urinary Na<sup>+</sup> and K<sup>+</sup> excretion was unchanged during the 2 and 5 µg/kg/min infusion rate, but fell by a mean of 31 and 21%, respectively, during the 10 µg/kg/min infusion dose of saralasin. Control ‘recumbent’ plasma renin activity and plasma aldosterone concentration were within the normal range for the established sodium intake. Mean PRA decreased dose-dependently from 1.86 ± 0.43 (C<sup>+</sup>) to 1.27 ± 0.40 ng/ml/3 h (10 µg/kg/min). However, plasma aldosterone concentration was unaffected during the low dose of saralasin, increased during the 5 µg/ kg/min dose (C<sup>+</sup>: 43.7 ± 8.5; 5 µg/kg/min: 78.4 ± 13.7 pg/ml), and returned into the control range during the 10 µg/kg/min infusion dose. Thus, saralasin at lower doses exhibited an angiotensin II agonistic effect on all receptor systems studied. Our findings exclude a major role of the renin-angiotensin-aldosterone system in the pathophysiology of impaired sodium balance in patients with nephrotic syndrome. They do, however, further support the hypothesis of functional differences between the vascular and adrenocortical angiotensin II receptors.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1980
          1980
          02 December 2008
          : 25
          : 4
          : 187-192
          Affiliations
          Medizinische Universitäts-Poliklinik, Bonn
          Article
          181779 Nephron 1980;25:187–192
          10.1159/000181779
          6990285
          © 1980 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 6
          Categories
          Original Paper

          Cardiovascular Medicine, Nephrology

          Nephrotic syndrome, Renal function, Renin, Aldosterone, Saralasin

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