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)

The renin angiotensin system is one of the most important humoral factors underlying the mechanism of hypertension. The genes constituting the renin angiotensin system have been expected to be candidates for essential hypertension. DNA polymorphisms of angiotensinogen and angiotensin II type 1 receptor genes are reported to be significantly related with the incidence of human hypertension, but further investigation is needed to clarify the relationship between the genes of the renin angiotensin system and hypertension. The renin angiotensin system exists not only in circulating blood, but also in extrarenal organs and tissues. Tissue renin angiotensin systems in the brain, blood vessels, and adrenal glands are considered to play important roles in the pressor mechanisms in low renin as well as high renin hypertension. Gene expressions of the constituents of the tissue renin angiotensin system are affected in part by circulating angiotensin II, but they are regulated mostly by their own specific control mechanisms in each organ and tissue. In future, laboratory tests in clinical medicine may be necessary to determine the DNA polymorphisms and tissue gene expression of renin angiotensin system, in deciding the diagnosis, prognosis and therapy of hypertension.
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PMID:[Role of renin angiotensin system in the vasopressor mechanisms of hypertension--gene analyses and tissue renin angiotensin system]. 855 76

In order to lower arterial blood pressure, antihypertensive drugs decrease cardiac output, total peripheral resistance or both. Diuretics, beta-blockers, and central adrenergic inhibitors decrease cardiac output. ACE inhibitors, angiotensin II antagonists, calcium antagonists, alpha-blockers, central adrenergic inhibitors, and after a delay also diuretics and beta-blockers decrease peripheral resistance. Diuretics are first line therapy for treating low renin hypertension. Beta blockers are used for treating high renin hypertension and patients suffering additional coronary artery disease. ACE inihibitors can be given for treating high renin hypertension particularly in conjunction with diabetes, heart failure or left ventricular hypertrophy. Combining ACE inhibitors with diuretics potentiates the antihypertensive effect. Angiotensin II antagonists exert fewer side effects and better renal protection than ACE inhibitors. The main indication for calcium antagonists is low renin hypertension, their advantages being strong blood pressure reduction as well as in preventing stroke. Central alpha2 receptor agonists and other vasodilators are chosen only in selected cases and mostly in combination with other antihypertensive drugs.
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PMID:[Pharmacological basis of antihypertensive drug therapy]. 1519 36

In the 1970s, pharmacological therapy interrupting the renin-angiotensin system was considered beneficial for patients with high-renin hypertension. This gave rise to the development of ACE inhibitors. Surprisingly, the ACE inhibitors proved to be effective not only in patients with high renin hypertension, but also in many patients with normal levels of plasma renin activity. At present ACE inhibitors have a significant position in a wide range of chronic illnesses such as atherosclerosis, hypertension, myocardial infarction, diabetic complications, stroke etc. They are combined safely with drugs like angiotensin receptor blockers, calcium channel blockers and thiazides with varying degree of benefits. Though they are safe drugs, patients need monitoring for renal insufficiency, hypotension, hyperkalemia etc. The safety of these drugs in paediatrics patients is not established. It is better to avoid these drugs during pregnancy.
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PMID:Therapeutic dimensions of ACE inhibitors--a review of literature and clinical trials. 1865 May 98

There are various causes of Reno Vascular Hypertension in children reported in the literature. Amongst these, Page kidney gets a rare mention. This phenomenon is a result of the accumulation of blood or urine in the perinephric or subcapsular space, resulting in compression of renal parenchyma, microvascular ischemia, alteration in the renin-angiotensin apparatus, and high renin hypertension. It has been well documented and studied in adults. Only a few cases are reported in the paediatric population. We report a rare presentation of Page kidney in a 5 year 8 months old girl. She initially presented with Dietl's crisis secondary to left Pelviureteric Junction obstruction (PUJO) causing massive hydronephrosis. She developed Page kidney phenomenon after spontaneous rupture of the pelvicalyceal system formed a tight compressive urinoma. She was managed successfully with internal JJ stenting and ultrasound-guided aspiration of the urinoma followed by elective delayed Pyeloplasty. To our knowledge, this is the first documented case of Page kidney in a child with severe PUJO.
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PMID:Page Kidney in a Child with Severe Pelviureteric Junction Obstruction. 3288 53


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