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)

Fibromuscular dysplasia of renal arteries was the cause of hypertension in four consecutive children with renal artery stenosis. Two were asymptomatic, the third had had hypertension for seven years but had not been treated, and the fourth, a 9-month-old infant, presented with cardiac failure. Heart enlargement and left ventricular hypertrophy were present in all. Rapid sequence urograms demonstrated a smaller kidney and delayed appearance and disappearance of the contrast medium on the affected side in all. Angiograms showed left RAS in all. Peripheral plasma renin activity was elevated in only three of the four patients. Antihypertensive and diuretic drugs were not very effective therapeutically. Ischemia of the ipsilateral kidney probably prevented normal growth and led to shrinkage of the kidney in one patient. Following nephrectomy the BP has remained normal without any therapy for 24 to 64 months. With normalization of BP, accelerated growth ensued, the cardiomegaly regressed and the hypertensive retinopathy resolved. These patients demonstrate that: (1) FMD is an important cause of RAS. (2) the well-known radiologic feature of FMD, the beaded appearance, is usually not seen in children. (3) control of BP leads to normalization of linear growth, usually impaired in severe hypertension, and (4) target organ complications such as cardiomegaly, LVH, and hypertensive retinopathy are reversible in one to 10 months.
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PMID:Fibromuscular dysplasia of renal arteries: an important cause of renovascular hypertension in children. 15 54

In the present study the effect of surgery on blood pressure was investigated in 35 patients with renovascular hypertension: 17 patients with fibromuscular hyperplasia (FMD) and 18 with atherosclerosis (ASS) of the renal artery. Patients with FMD were younger (31,8 years), showed a shorter duration of hypertension (1.8 years) and were prevalently female (82%), whereas patients with ASS were markedly older (48.2 years), showed a longer duration of hypertension (2.6 years) and were most often male (78%). In both groups of patients the intravenous urogram was positive in a comparable high percentage (FMD=64%, ASS=61%). Following surgical intervention 47%(n=8) of the 17 patients with FMD were cured, 47% (n=8) were improved and only 6% (n=1) showed insufficient reduction of blood pressure values. In ASS the respective values were 28, 55 and 17%. Consequently a good effect of surgery (cured and improved) was observed in 88.5% of all patients. Patients with ASS who failed to respond to surgery (n=3) showed a remarkable long duration of hypertension (7.0 plus or minus 1.4 years). Plasma renin activity (PRA) was determined preoperatively in both renal veins in all 35 patients. From these values the PRA-ratio (PRA affected/unaffected side) was calculated. In 27 patients PRA determinations were repeated following (15 and 30 min) intravenous injection of 40 mg furosemide. PRA-ratios of larger than or equal to 1.5 were considered to be significant. In 31 patients with unilateral renovascular hypertension PRA-ratios were correlated to the postoperative blood pressure reduction. No significant differences in mean PRA-ratios were observed between cured and improved patients. Furthermore, for the total group of 31 patients no significant correlations were obtained between PRA-ratios and postoperative blood pressure reduction. Our results do not support the widespread opinion that PRA determinations in both renal veins are useful to predict the effect of surgery in patients with unilateral renovascular disease. Therefore, from our experience this method should not be recommended as obligatory in the diagnostic work-up of renovascular hypertension.
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PMID:[Renovascular hypertension. Prognostic value of renal venous renin determinations (author's transl)]. 50 54

The gain in the diagnostic power of the routine preoperative bilateral renal vein renin investigation by the inclusion of an acute stimulation of renin release was studied in 25 hypertensive patients with fibromuscular (FMD) and 44 with arteriosclerotic (AS) renovascular disease. Nine FMD and 17 AS patients had renal vein renin ratios greater than or equal to 1.50 under unstimulated conditions. Of these 26 patients, 8 in each group improved after surgical treatment. Among the 14 FMD and 24 AS patients with ratios less than 1.50, another 9 FMD and 7 AS patients improved after operation. After acute stimulation of renin release, no less than 18 FMD and 26 AS patients had a unilateral renin secretion from the diseased kidney and of these, 14 FMD and 14 AS patients were successfully treated with operation of the stenosis. Thus the stimulation was necessary for correct preoperative diagnosis in 38% of 32 successfully operated patients, and at the same time the predictive value of a negative test increased from 0.58 to 0.80. It is concluded that acute stimulation of renin release greatly improves the diagnostic power of the renal vein renin investigation in renovascular hypertension.
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PMID:Preoperative diagnosis of renovascular hypertension. The use of acute stimulation of renin secretion. 637 75

Activation of the renin-angiotensin-aldosterone system plays an important role in the pathogenesis of endothelial dysfunction and atherosclerosis. Studies evaluating the effect of AT1-receptor blockers on endothelial dysfunction in patients with coronary artery disease (CAD) revealed mixed results. Studies addressing the effects of AT1-receptor blockers on the coronary and peripheral function in the same study population, are still lacking. We therefore aimed to test the effects of long-term therapy with the AT1-receptor blocker irbesartan (IRB) on both, the coronary and peripheral endothelial function in patients with CAD. Seventy-two patients with CAD were randomly assigned to double-blinded treatment for 6 months with IRB 300 mg per day or placebo, respectively. Coronary and peripheral endothelial function were measured by intracoronary infusion of acetylcholine (final intracoronary concentration 10(-7.3) to 10(-5.6)M) and by determining flow-dependent dilation (FMD) of the brachial artery, respectively. IRB significantly improved FMD, while no change of coronary endothelial function was observed. Interestingly, plasma levels of N(G),N(G)-dimethyl-arginine, and the isoprostane excretion rate were not modified. IRB treatment improves peripheral but not coronary endothelial dysfunction in patients with CAD. Since reduced FMD of the brachial artery has been shown to be associated with a high-cardiovascular event rate, improvement of FMD by IRB may lead to better prognosis of patients with CAD.
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PMID:AT1-receptor blockade with irbesartan improves peripheral but not coronary endothelial dysfunction in patients with stable coronary artery disease. 1697 Sep 50