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)

Serum angiotensin-I-converting enzyme activity was found to be elevated in infants with idiopathic respiratory distress syndrome when compared with healthy premature infants, normal infants, and acutely ill full-term infants. Serum and lung CE activity has been found to be elevated in mice exposed to hypobaric alveolar hypoxia which also stimulated renal renin production. These findings suggest that alveolar hypoxia stimulates the renin-angiotensin-aldosterone system and this system may be involved in the response to the stress of IRDS.
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PMID:Angiotensin-I-converting enzyme activity in idiopathic respiratory distress syndrome of the newborn infant and in experimental alveolar hypoxia in mice. 16 36

Attention is called to a poorly recognized syndrome of neonatal renal arterial embolism, presumably from the ductus arteriosum, resulting in malignant hypertension, congestive heart failure, respiratory distress, and increased renin secretion. Radiographic studies revealed a ductus diverticulum and multiple narrowed arteries including the lower pole branches of the right renal artery. Renal scan showed poor imaging of the lower pole of the right kidney. Nephrectomy resulted in a prompt return of the blood pressure into the normal range. Eight cases recorded in the literature resemble the one reported here, and six of the eight had an associated thrombosis of the ductus arteriosum. Our patient appears to be the first case recognized by modern techniques followed by nephrectomy and clinical cure.
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PMID:Neonatal renal arterial embolism syndrome. 99 27

Angiotensin converting-enzyme inhibitors cross the placenta and modify the maternal, foetal and utero-placental renin-angiotensin system. Eight cases of pregnancy in women taking captopril have been published, 7 other cases being reported in this review paper. There were one spontaneous and 2 therapeutic abortions, one of which disclosed a malformation of uncertain diagnosis and imputation. One intrauterine death at 28 weeks was probably due to the severity of the maternal disease. Two children born to mothers also treated with frusemide died of neonatal anuria. Delivery or caesarean section occurred before term in 8 cases, and there were 3 cases of neonatal respiratory distress with a favourable outcome. Finally, one mother gave birth at term to twins of normal weight. The cases with respiratory distress can be attributed to the mother's hypertension, to prematurity and/or to concomitant treatment with beta-blockers, while the cases with anuria seem to be due to inhibition of the effects of angiotensin on renal haemodynamics, with salt depression as a possible aggravating factor. Treatment with angiotensin converting enzyme inhibitors does not seem to warrant therapeutic abortion. However, these drugs are contra-indicated in pregnancy and should only be given to women wishing to become pregnant if they present with resistant and dangerous arterial hypertension. A programme of pharmacovigilance is being set up to follow up such pregnancies.
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PMID:[Inhibition of angiotensin converting enzyme in human pregnancy. 15 cases]. 300 90

A newborn male with a large diaphragmatic hernia presented in severe respiratory distress. Additional features included a paucity of subcutaneous tissue, mild facial dysmorphism, webbing of the neck, genital hypoplasia, and flexion contractures of the fingers. His karyotype showed a previously unreported de novo interstitial deletion of the long arm of chromosome 1 [46,XY,del(1)(pter----q32.3::q42.3----qter)]. Regional mapping of five human genes that have been provisionally assigned to chromosome 1 was performed by restriction analysis of genomic DNA from this patient. Glucocerebrosidase, H4 histone, renin, and alpha-spectrin genes mapped outside the deleted region, whereas an H subunit of the ferritin gene mapped to 1q32----q42. These results indicate the utility of chromosomal deletions in gene mapping, and the importance of karyotype analysis in newborns with diaphragmatic hernias.
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PMID:Association of a new chromosomal deletion [del(1)(q32q42)] with diaphragmatic hernia: assignment of a human ferritin gene. 316 27

Renovascular hypertension is more common in hypertensive children than in hypertensive adults, and renal artery stenosis is second only to coarctation of the thoracic aorta as a cause of surgically correctable hypertension. Three infants presented with uncontrollable hypertension secondary to renal artery thrombosis due to umbilical artery catheterization for respiratory distress in the neonatal period. They all responded to nephrectomy. A fourth infant had stenosis of a polar vessel secondary to umbilical artery catheterization and was cured by partial nephrectomy. Two infants with renal artery stenosis secondary to fibromuscular dysplasia benefited from revascularization and, at last follow-up, were normotensive and off all blood pressure medication. Ultrasonography, isotope scanning, angiography and selective renal vein renin assays should be used to identify patients with surgically correctable lesions. The use of fine suture material and microvascular surgical techniques, including ex vivo revascularization and autotransplantation, can salvage renal parenchyma and relieve hypertension. Infants with less than 10 percent renal function on the involved side should have a nephrectomy. The infant with an umbilical arterial catheterization line needs blood pressure monitoring and aggressive evaluation and treatment of persistent hypertension.
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PMID:Early diagnosis and management of renovascular hypertension. 355 43

Shortly after birth, a 1,860-g premature male newborn with respiratory distress syndrome had brisk diuresis, rapid weight loss, and severe hyponatremia despite aggressive Na+ and fluid replacement. The serum cortisol level was normal, and the 17-OH progesterone concentration was low. He did not show any response to treatment with dexamethasone and desoxycorticosterone acetate. Results of renal function studies were within the normal range for his gestational age. The serum aldosterone level and plasma renin activity were grossly elevated, confirming the diagnosis of pseudohypoaldosteronism. This uniquely early and dramatic presentation was attributed to immaturity of the proximal renal tubule at 32 weeks' gestation. The subsequent improvement paralleled the rapid maturation of the kidney after birth.
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PMID:Pseudohypoaldosteronism. 634 58

Perinatal anoxia, or postnatal hypoxemia, as seen during respiratory distress syndrome, profoundly affects renal function. Hypoxemic neonates present with decreased water excretion, impaired diluting ability, urine acidification, glomerular filtration rate and renal perfusion. Stimulation of the renin-angiotensin system may explain, at least in part, the pathogenesis of the hypoxemia-induced renal changes. The renal defects are reversible upon restoring normoxemia, extracellular fluid volume and cardiac output. The neonatal kidney can also be affected by iatrogenic manipulations. Drugs acting efficiently on several target-organs can profoundly impair renal function. Tolazoline, sometimes used as a pulmonary vasodilator in persistent pulmonary hypertension of the premature infant, can increase renal vascular resistance with consequent renal failure. Indomethacin, a prostaglandin-synthetase inhibitor used to medically close a patent ductus arteriosus, can depress glomerular filtration and water excretion in the newborn infant. Aminoglycosides are widely used in neonatology. They can easily accumulate in neonates whose GFR is low. Their nephrotoxicity may be lower in neonates than in adults, but is certainly not negligible. Experimental studies and a clinical observation have shown that captopril, a competitive inhibitor of the angiotensin-converting enzyme can produce renal damage in the fetus. Recent progress in pharmacology has provided the neonatologist with effective drugs which are of great value in the neonatal ward. They should however always be used with caution if detrimental side-effects are to be avoided.
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PMID:[Renal disorders in the newborn infant]. 639 26

The overall incidence of clinically important (moderate to severe) OHSS ranges from 1% to 10% of IVF cycles, but only a small proportion (0.5% to 2%) of the cases are severe. In extreme but rare cases, secondary complications such as deep vein thrombosis, respiratory distress and acute hepato-renal failure may occur. The main risk factors are the presence of polycystic ovaries, high ovarian response to superovulation therapy, the use of hCG to trigger the ovulatory process or for luteal phase support, and the endogenous production of hCG by an early pregnancy. The pathogenesis of OHSS is unknown, although the predominant biochemical mediator is thought to be the renin-angiotensin system. Ovarian stimulation should always be carefully monitored to identify those women at risk. In IVF cycles, the hCG injection should be withheld if the risk is judged to be too great. Some women will benefit from a policy of proceeding to collect oocytes, but electively cryopreserving any resulting embryos, thus allowing the ovarian stimulation cycle not to be wasted. The administration of albumin at the time of oocyte collection will reduce the chance of severe OHSS occurring. If a decision is made to proceed with oocyte recovery and embryo transfer, it may be advisable to give 5000 IU of hCG, rather than 10,000 IU, as the ovulatory trigger. Progesterone, and not hCG, should be given in the luteal phase. Women developing mild or moderate OHSS should be kept under outpatient surveillance to detect the minority that may progress to severe OHSS. Those with severe OHSS should be hospitalised for fluid and electrolyte management. Paracentesis under ultrasound guidance is recommended where there are tense ascites, but further surgical intervention should rarely be undertaken and only when there is good clinical evidence of ovarian torsion or haemorrhage.
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PMID:Diagnosis, prevention and management of ovarian hyperstimulation syndrome. 862 33

In humans, urine formation starts with the metanephros at the 10th week of gestation. Nephrogenesis progresses during gestation and is achieved around the 35th week. Clamping of the cord is the signal for a striking increase in renal function which reaches mature levels at the end of the first year of life. The integrity of several hormonal systems (the renin-angiotensin system, the prostaglandins) is mandatory for kidney growth and the development of renal function. The mechanisms underlying renal homeostasis are fragile and can easily be disturbed during respiratory and cardiovascular distress, or be affected by the administration of vasoactive agents. Thus, perinatal asphyxia or hypoxemia, as seen in respiratory distress syndrome or neonatal pulmonary hypertension induces intense renal vasoconstriction, with consequent oligoanuria. Congestive heart failure also results in renal hypoperfusion and sodium retention. Vasoactive agents and diuretics (indomethacin, tolazoline, furosemide) used to threat these conditions can result in renal vasoconstriction, renal hypoperfusion and failure. The pathogenesis and pathophysiology of neonatal renal disturbances being now better defined, a rational approach to the treatment of renal functional abnormalities during the neonatal period is possible.
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PMID:[The immature kidney]. 756 36

Atrial natriuretic peptide (ANP), plasma renin and renin substrate concentrations (PRC and PRS) were measured in 31 preterm infants with idiopathic respiratory distress syndrome. Infants were studied at a mean of 1.4 days; 17 infants were also studied 2 days later. A 6-hour urine collection was made from 13 male infants on the first day of sampling to assess renal function. Both ANP and PRC were elevated and showed wide ranges of values (geometric means of 620 pg/ml and 18.4 ng/ml/h). Plasma ANP was significantly correlated with pH, PaCO2 and base excess. No correlations with parameters of cardiovascular or renal function were found. Plasma ANP rose in 13 of the 17 paired samples. We suggest that the very high ANP concentrations in these babies are a consequence of the pulmonary haemodynamic disturbances which accompany respiratory distress in the newborn.
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PMID:Atrial natriuretic peptide in the preterm newborn. 794 37


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