RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM  IN CHRONIC KIDNEY  DISEASE

A. Zh. Karabaeva; I. G. Kayukov; A. M. Essaian; A. V. Smirnov

doi:10.24884/1561-6274-2006-10-4-43-48

RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM IN CHRONIC KIDNEY DISEASE

A. Zh. Karabaeva, I. G. Kayukov, A. M. Essaian, A. V. Smirnov

https://doi.org/10.24884/1561-6274-2006-10-4-43-48

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Abstract

THE AIM of the investigation was to specify the role of components of the renin–ngiotensin-aldosterone system (RAAS) in progressing chronic kidney disease, its renal and cardiovascular injuries. PATIENTS AND METHODS. The concentration of plasma aldosterone (CPA), plasma renin activity (PRA), blood serum creatinine (SCr), creatinine clearance (CCr), total renin plasma (TR), inactive plasma renin (IR) were determined in 214 patients with different forms of chronic glomerulonephritis and different stages of chronic kidney disease (CKD).RESULTS. Increased CPA was noted in the progress of CKD, clear inverse nonlinear dependence between CCr and CPA was established. The linear correlation analysis has revealed highly reliable direct correlation between SCr and CPA and confirmed the inverse correlation between CCr and CPA. No relationships were found between the investigated components of RAAS and levels of arterial pressure, although there were correlations of PRA with TR and of IR with TR. A statistically significant feedback was found between PRA and SCr. CONCLUSION. Aldosterone, A II and rennin can be substantial independent factors of the development and progress of renal and cardiovascular complications in patients with CKD.

Keywords

renin-angiotensin-aldosterone system, chronic kidney disease, renal and cardiovascular complications

About the Authors

A. Zh. Karabaeva

Научно-исследовательский институт нефрологии Санкт-Петербургского государственного медицинского университета им. акад. И.П. Павлова
Russian Federation

I. G. Kayukov

A. M. Essaian

A. V. Smirnov

References

1. Jalil JE, Janicki JS, Pick R, Weber KT. Coronary vascular remodeling and myocardial fibrosis in the rat with renovascular hypertension: response to captopril. Am J Hypertens 1991; 4: 51–55

2. Weber KT. Aldosterone in congestive heart failure. N Engl J Med 2001; 345: 1689 – 1697

3. Epstein M. Aldosterone as a mediator of progressive renal dysfunction: evolving perspectives. Intern Med. 2001 Jul; 40(7):573-83

4. Рябов СИ, Каюков ИГ, Гадаев АГ и др. Морфофункциональные параллели при артериальной гипертензии у больных хроническим гломерулонефритом. Тер арх 1992; (6): 26-29

5. Котовой ЮО. Изменения ренин-ангиотензин-альдостероновой системы при гломерулонефрите. Урология и нефрология 1989; (5): 53-58

6. Каюков ИГ. Особенности нарушений водно-солевого гомеостаза у больных хроническим гломерулонефритом в доазотемическом периоде. Дисс. докт. мед. наук... СПб, 1994

7. Гадаев А. Механизмы артериальной гипертензии при хроническом гломерулонефрите. Дисс. докт. мед. наук...СПб, 1992

8. Котовой ЮО. Сосотояние ренин-ангиотензин-альлдостероновой системы при гломерулонефрите в динамике развития почечной недостаточности. Дисс. канд. мед. наук...СПб, 1986

9. Osmond DH, Loh EK, Loh AY et al. Kallikrein and plasmin as activators of inactive renin. Lancet 1978; 2, 8104-5: 1375-1376

10. Quan ZY, Walser M, Hill GS. Adrenalectomy ameliorates ablative nephropathy in the rat independently of corticosterone maintenance level. Kidney Int 1992; 41: 326–333

11. Nishiyama A, Yao L, Nagai Y et al. Possible contributions of reactive oxygen species and mitogen-activated protein kinase to renal injury in aldosterone/salt-induced hypertensive rats. Hypertension 2004; 43: 841–848

12. Blasi ER, Rocha R, Rudolph AE et al. Aldosterone/salt induces renal inflammation and fibrosis in hypertensive rats. Kidney Int 2003; 63: 1791–1800

13. Peng H, Carretero OA, Raij L et al. Antifibrotic effects of N-acetyl-seryl-aspartyl-Lysyl-proline on the heart and kidney in aldosterone-salt hypertensive rats. Hypertension 2001; 37: 794–800

14. Nishiyama A, Abe Y. Molecular mechanisms and therapeutic strategies of chronic renal injury: renoprotective effects of aldosterone blockade. J Pharmacol Sci 2006 Jan; 100(1): 9-16. Epub 2006 Jan 6

15. Greene EL, Kren S, Hostetter TH. Role of aldosterone in the remnant kidney model in the rat. J Clin Invest 1996; 98: 1063–1068

16. Rocha R, Chander PN, Khanna K et al. Mineralocorticoid blockade reduces vascular injury in stroke-prone hypertensive rats. Hypertension 1998; 31: 451–458

17. Conn JW, Knopf RF, Nesbit RM. Clinical characteristics of primary aldosteronism from an analysis of 145 cases. Am J Surg 1964; 107: 159-172

18. Nishimura M, Uzu T, Fujii T et al. Cardiovascular complications in patients with primary aldosteronism. Am J Kidney Dis 1999; 33: 261-266

19. Ribstein J, Du Cailar G, Fesler P, Mimran A. Relative glomerular hyperfiltration in primary aldosteronism. Am J Hypertens 2005 Jan; 18(1): 50-5

20. Epstein M. Aldosterone as a determinant of cardiovascular and renal dysfunction. J R Soc Med 2001 Aug; 94(8): 378-83

21. Connell JMC, Davies E. The new biology of aldosterone. J Endocrinology 2005; 186: 1-20

22. Epstein M. Aldosterone receptor blockade and the role of eplerenone: evolving perspectives. Nephrol Dial Transplant 2003 Oct; 18(10): 1984-1992

23. Мухин НА, Моисеев ВС, Кобалава ЖД, Моисеев СВ, Фомин ВВ. Кардиоренальные взаимодействия: клиническое значение и роль в патогенезе заболеваний сердечно-сосудистой системы и почек.Тер арх 2004; 76 (6):39-47

24. Карабаева АЖ. Альдостерон, сердечно-сосудистая система и почки. Нефрология 2006; 1(10): 25-34

25. Есаян АМ, Каюков ИГ, Карабаева АЖ. Минералкортикоидные рецепторы: строение, механизмы активации. Нефрология 2006; 2 (10): 28-32

26. Зверев ЯФ, Брюханов ВМ. Современные представления о механихмах почечного действия альдостерона. Нефрология 2001; 4(5): 9-16

27. Duprez D, de Buyzere M, Rietzchel ER, Clement DL. Aldosterone and vascular damage. Curr Hypertens Rep 2000; 2: 327-334

28. Epstein M. Aldosterone receptor blockade and the role of eplerenone: evolving perspectives. Nephrol Dial Transpl 2003; 18: 1984-1992

29. Fuller PJ, Young MJ. Mechanisms of mineralocorticoid action. Hypertension 2005; 46: 1227-1246

30. Weber KT, Anversa P, Armstrong PW et al. Remodeling and reparation of the cardiovascular system. J Am Coll Cardiol 1992; 20: 3-16

31. Nancy J. Brown, Kyung-Soo Kim, Yan-Qun Chen et al. Synergistic effect of adrenal steroids and angiotensin II on plasminogen activator inhibitor-1 production 1. J Clinl Endocrinol Metabo 2000; 85(1): 336-344

32. Epstein M. Aldosterone as a mediator of progressive renal disease: Pathogenetic and clinical implications.Am J Kidney Dis 2001; 37: 677-688

33. Brown NJ, Vaughan DE, Fogo AB. Aldosterone and PAI – 1: implications for renal injury. J Nephrol 2002; 15 (3): 230-235

34. Huang Y, Wongamorntham S, Kasting J et al. Renin increases mesangial cell transforming growth factor-beta1 and matrix proteins through receptor-mediated, angiotensin II-independent mechanisms.Kidney Int 2006; 69 (1): 105-113

Review

For citations:

Karabaeva A.Zh., Kayukov I.G., Essaian A.M., Smirnov A.V. RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM IN CHRONIC KIDNEY DISEASE. Nephrology (Saint-Petersburg). 2006;10(4):43-48. (In Russ.) https://doi.org/10.24884/1561-6274-2006-10-4-43-48

ISSN 1561-6274 (Print)
ISSN 2541-9439 (Online)

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Nephrology (Saint-Petersburg)