Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.23.15 (renin)
 35,795 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report on 15 patients operated upon for renovascular hypertension associated with bilateral renal artery stenosis. Followup has been for 1 to 12 years. Four of 5 patients with positive split renal function studies and 3 of 5 patients with positive renal vein renin assays underwent unilateral operations on the positive side. All of these patients were cured or improved. The guide for unilateral operations in hypertensive patients with bilateral renal artery stenosis by angiography was the physiological information obtained from the preoperative screening tests, especially the plasma renin activity ratios of the 3 different veins and the split renal function studies.
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PMID:Surgical treatment of renovascular hypertension associated with bilateral renal artery stenosis. 71 91

The mechanisms involved in residual or recurrent hypertension following operation to correct renal artery stenosis were studied in 10 patients by performing angiotensin II blockade with Saralasin (Sarcosine, alanine, angiotensin II) before and after operation. Peripheral renin and renal vein renin determinations, angiography, and renography were done as well. The limitations of renin determinations are cited and the application of angiotensin II blockade as a specific method of detecting renin-dependent hypertension before and after operation are presented. Saralasin infusion under the controlled conditions of our study proved to be a sensitive method for detection of renin-dependent hypertension. The results of Saralasin infusion correlated closely with peripheral and renal vein renin determinations. Thus angiotensin II blockade before and after operation may supercede more invasive and less specific diagnostic methods.
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PMID:Evaluation of surgical response in renovascular hypertension using angiotensin II blockade. 71 82

The effect of removal of one renal artery stenosis on renal sodium and fluid excretion and on the activity of the renin-angiotensin system (RAS) has been investigated in three types of renal hypertension of rats. Blood pressure fell in all experimental models after declamping, independently of changes in urinary sodium and water excretion or plasma angiotensin II (ANG II). Plasma concentrations of ANG II did not rise in response to salt and fluid loss induced by declamping when the contralateral kidney had been removed or when it was depleted from renin. A high renin content of the declamped kidney prevented major salt and fluid loss, whereas renin depletion of this kidney was accompanied by an exaggerated natriuresis and diuresis. Besides this tubular modulation of renal salt and water handling by the local RAS, glomerular filtration rate could be reduced by a stimulated activity of this system in plasma, indicated by a close relationship between serum urea and plasma ANG II levels.
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PMID:Reversal of renal hypertension: effects on renin, salt and water balance. 73 50

Renal artery stenosis causing hypertension has been noted in 11 patients after successful renal transplantations. We believe that all patients with moderate to severe post-transplant hypertension should be evaluated with angiography and selective renin determinations. However, because of definite risk to the graft we believe that operative intervention should be undertaken only if hypertension is uncontrolled or if declining renal function is present and attributable to the stenosis.
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PMID:Diagnosis and management of arterial stenosis causing hypertension after successful renal transplantation. 78 8

Plasma renin activity (PRA) was measured in nine renal transplant recipients, seven of which had transplant renal artery stenosis. Surgical correction of the stenosed renal transplant artery was performed in six patients. After corrective surgery of the stenosed artery hypertension (mean arterial pressure before operation 156 mmHg) improved (mean arterial pressure postoperatively 110 mmHg) in four patients with high peripheral PRA (17.3+/-3.9 ng/ml. hr). Two patients, one hypertensive, the other normotensive with low PRA (1.5+/-0.05 ng/ml. hr) had no change in their blood pressure after corrective surgery. In three hypertensive renal transplant recipients the PRA of the venous effluent of the own kidneys and the renal transplant were studied selectively. Selective PRA determinations revealed the source of inappropriate renin secretion offering a basis for surgical management of the assocaited hypertension.
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PMID:Plasma renin activity in the evaluation of hypertension in renal transplant recipients. 78 11

In Europe, about 1% of the women using oral contraceptives develop hypertension. Predisposing factors seem to be age, hypertension problems in past pregnancies, family history of hypertension, personal histories of kidney disorders, diabetes mellitus or adipositas, or diastolic pressure over 80 mm Hg. An overactive renin-angiotensin-aldosterone system may be an important factor in the etiology of this type of hypertension. Oterh possible factors are: reduced excretion of angiotensin 2, increased sensitivity of the arterioles to substances such as angiotensin 2 and noradrenaline, direct effect of ethinyl estradiol and mestranol on the sodium and water system, cardiovascular changes, disorders in the adrenergic system (e.g., catecholamine metabolism). Blood pressure should be checked before beginning any treatment with oral contraceptives and every 3 months after that. For the purpose of differential diagnosis angiotensin 2 in the plasma and catecholanin and its by-products should be checked (24-hour urine samples). In cases of serious hypertension hormone therapy should be discontinued at once. Primary aldosteronism and renal artery stenosis must be excluded in the differential diagnosis, for although these hypertensive disorders exhibit similar biochemical changes, they should be treated by surgical intervention. Usually hypertension is reversible after cessation of therapy with contraceptive steroids. However, some cases of irreversible hypertention, kidney failure, and malignant nephrosclerosis have been described. Hypertensive somen who wish to use oral contraceptives may, under medical supervision try a modified hormonal contraceptive (minipill without estrogen) or sequential or lower dosages.
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PMID:[Clinical aspects of hypertension under contraceptive steroids]. 79 66

In about 15% of cases hypertension is caused by renal diseases, including unilateral and bilateral parenchymatous nephropathies, renal artery stenosis and renin producing tumors. Important pathogenic determinants are the sodium volume status and the renin angiotensin system. The level of the blood pressure may also depend on the duration of hypertension. An increase in peripheral resistance plays a more important role than an increase in cardiac index. Simultaneous determination of the renin activity in both renal veins is of decisive importance in the diagnosis of renal artery stenosis. Drug treatment of renal hypertension is not essentially different from that of essential hypertension. Surgical procedures include revascularization, uninephrectomy and, in uncontrollable hemodialysis patients, binephrectomy.
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PMID:[Renal hypertension]. 79 75

Angiotensin antagonists have become useful tools in studying pharmacologic and pathophysiologic roles of the renin-angiotensin axis. Several of these uses are described herein. Their value as t-ols in the diagnosis of renal artery stenosis is yet to be determined.
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PMID:Angiotensin antagonists as diagnostic and pharmacologic tools. 79 3

A case of hypertension in a patient with neurofibromatosis and renal artery stenosis with aneurysm formation in a solitary kidney is described. Studies of plasma renin activity and body sodium content are presented and have been related to findings in patients and experimental animals with renovascular hypertension. A reconstructive operative procedure is described in which the kidney is perfused in situ.
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PMID:Hypertension and renal artery stenosis with aneurysm formation in a solitary kidney in a patient with neurofibromatosis. 80 81

Fifty patients who underwent renal angiography and bilateral renal venous determinations had reconstructive or ablative surgery. The importance of stimulating renin release was underlined in 11 patients who attained a renal venous ratio greater than 1.5 to 1 only after being in an upright posture and in 5 who were studied with and without salt depletion. A protocol designed to suppress or stimulate peripheral plasma renin activity was followed in 19 patients. Stimulated peripheral plasma renin activity was not useful in identifying hypertension of renovascular origin but 10 of 12 patients whose plasma renin activity was not suppressed normally were improved by an operation. Satisfactory surgical responses were obtained in 81 per cent of the patients with unilateral and 91 per cent with bilateral atherosclerosis, and 88 per cent with unilateral and 60 per cent with bilateral fibromuscular hyperplasia. Our observations indicate that renal artery stenosis can be identified consistently only by angiography. A stimulated renal venous renin rate of 1.5 to 1 appears to have the best predictive value in surgical control of renovascular hypertension.
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PMID:Improved diagnostic accuracy of renal venous renin ratios with stimulation of renin release. 83 54


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