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The Physiology of Renin

The Physiology of Renin Abstract Renin plays a significant role in normal and pathophysiologic states. Among the various factors affecting renin secretion are the afferent arteriole acting as a baroreceptor, the macula densa as a sensor of sodium delivery to the distal tubule, and the adrenergic nervous system. There is contrasting evidence for a potential role of intrarenal renin in autoregulating the renal blood flow and glomerular filtration rate. Levels of plasma renin vary with the clinical setting. Emphasis is placed on the role of renin in controlling effective blood volume through its effect on vascular tone and volume by release of angiotensin and aldosterone. References 1. Tigerstedt R, Bergmann PG: Niere und Kreislauf. Skandinav Arch Physiol 8:223-228, 1898.Crossref 2. Goldblatt H, et al: Studies on experimental hypertension: I. The production of persistent elevation of systolic blood-pressure by means of renal ischemia. J Exp Med 59:347-354, 1934.Crossref 3. Braun-Menendez E, et al: The substance causing renal hypertension. J Physiol 98:283-298, 1940. 4. Page IH, Helmer OM: Angiotonin activator, renin and angiotonin-inhibitor and the mechanism of angiotonin tachyphylaxis in normal, hypertensive and nephrectomized animals. J Exp Med 71:495-501, 1940.Crossref 5. Skeggs LT, Kahn JR, Shumway NP: The purification of hypertensin II. J Exp Med 103:301-308, 1956.Crossref 6. Elliott DF, Peart WS: Amino acid sequence in a hypertensin. Nature (Lond) 117:527-528, 1956.Crossref 7. Schwyzer R, et al: Synthese hochwirksamer Dekapeptide mit der Aminosauresequenz des val5-hypertensins I. Helv Chim Acta 41:1273-1276, 1958.Crossref 8. Genest J, et al: Adrenocortical function in essential hypertension , Buchborn C, Bock KD (eds): in Essential Hypertension: An International Symposium . Berlin, Springer-Verlag, 1960, pp 126-146. 9. Laragh JH, et al: Hypotensive agents and pressor substances: The effect of epinephrine, norepinephrine, angiotensin II and others on the secretory rate of aldosterone in man. JAMA 174:234-240, 1960.Crossref 10. Goormaghtigh N: Existence of an endocrine gland in the media of the renal arterial. Proc Soc Exp Biol Med 42:688-689, 1939.Crossref 11. Tobian L, Janecek J, Tomboulian A: Correlation between granulation of juxtaglomerular cells and extractable renin in rats with experimental hypertension. Proc Soc Exp Biol Med 100:94-96, 1959.Crossref 12. Pitcock J, Hartroft P, Newmark L: Increased renal pressor activity (renin) in sodium-deficient rats and correlation with juxtaglomerular granulation. Proc Soc Exp Biol Med 100:868-869, 1959.Crossref 13. Cook W, Pickering G: Location of renin within kidney. J Physiol (Lond) 143:78P-79P, 1958. 14. Bing J, Wiberg B: Localization of renin in kidney. Acta Pathol Microbiol Scand 44:138-142, 1958.Crossref 15. Bing J, Kazimierczak J: Renin content of different parts of periglomerular circumference. Acta Pathol Microbiol Scand 50:1-11, 1960.Crossref 16. Granger P, Dahlheim H, Thurau K: Enzyme activities of the single juxtaglomerular apparatus in the rat kidney. Kidney Int 1:78-88, 1972.Crossref 17. Hartroft P: Juxtaglomerular cells. Circ Res 12:525-530, 1963.Crossref 18. Hartroft P, Sutherland L, Hartroft W: Juxtaglomerular cells as the source of renin: Further studies with the fluorescent antibody technique and the effect of passive transfer of anti-renin. Can Med Assoc J 90:163-166, 1964. 19. Robertson A, et al: Renin production by organ culture of renal cortex. Science 149:650-651, 1965.Crossref 20. Robertson A, et al: Production of renin by human juxtaglomerular cells in vitro. Circ Res 18( (suppl) ):131-142, 1966.Crossref 21. Huidobro F, Braun-Menendez E: The secretion of renin by the intact kidney. Am J Physiol 137:47-55, 1942. 22. Skinner S, McCubbin J, Page I: Control of renin secretion. Circ Res 15:64-76, 1964.Crossref 23. Spath J Jr, et al: Effect of acute local renal hypoxia on renin activity in renal venous blood. Proc Soc Exp Biol Med 137:484-488, 1971.Crossref 24. Tobian L, Tomboulian A, Janecek J: Effect of high perfusion pressures on the granulation of juxtaglomerular cells in an isolated kidney. J Clin Invest 38:605-610, 1959.Crossref 25. Vander A, Miller R: Control of renin secretion in the anesthetized dog. Am J Physiol 207:537-546, 1964. 26. Blaine E, Davis J, Witty R: Renin release after hemorrhage and after suprarenal aortic constriction in dogs without sodium delivery to the macula densa. Circ Res 27:1081-1089, 1970.Crossref 27. Blaine E, Davis J: Evidence for a renal vascular mechanism in renin release: New observations with graded stimulation by aortic constriction. Circ Res 18 ( (suppl) ):118-126, 1971. 28. Witty R, et al: Effects of papaverine and hemorrhage on renin secretion in the non-filtering kidney. Am J Physiol 221:1666-1671, 1971. 29. Guyton A, Langston J, Navar G: Theory for renal autoregulation by feedback of the juxtaglomerular apparatus. Circ Res 15- (1) (suppl 1):187-197, 1964. 30. Vander A: Effect of catecholamines and the renal nerves on renin secretion in anesthetized dogs. Am J Physiol 209:659-662, 1965. 31. Landwehr D, et al: Effect of reduction in filtration rate on renal tubular sodium and water reabsorption. Am J Physiol 215:687-695, 1968. 32. Glabman S, Aynedjian H, Bank N: Micropuncture study of the effect of acute reductions in glomerular filtration rate on sodium and water reabsorption by the proximal tubules of the rat. J Clin Invest 44:1410-1416, 1965.Crossref 33. DiBona G: Effect of mannitol diuresis in ureteral occlusion on distal tubular reabsorption. Am J Physiol 221:511-514, 1971. 34. Vander A, Luciano J: Effects of mercurial diuresis and acute sodium depletion on renin release in dog. Am J Physiol 212:651-656, 1967. 35. Brown T, Davis J, Johnston C: Acute response in plasma renin and aldosterone secretion to diuretics. Am J Physiol 211:437-441, 1966. 36. Vander A, Carlson J: Mechanism of the effect of furosemide on renin secretion in anesthetized dogs. Circ Res 25:145-152, 1969.Crossref 37. Cooke R, et al: The effect of altered sodium concentration in the distal nephron segments on renin release. J Clin Invest 49:1630-1638, 1970.Crossref 38. Nash R, et al: Renin release: Relation to renal sodium load and dissociation from hemodynamic changes. Circ Res 22:473-487, 1968.Crossref 39. Thurau K, et al: Composition of tubular fluid in the macula densa segment as the factor regulating the function of the juxtaglomerular apparatus. Circ Res 20( (suppl 2) ):79-89, 1967. 40. Thurau K, et al: Functional and enzymatic analysis of single juxtaglomerular apparatuses , in Genest J, Koiw E (eds): Hypertension '72 . Berlin, Springer-Verlag, 1972, pp 63-72. 41. Wathen R, et al: Effects of infusions of catecholamines and angiotensin II on renin release in anesthetized dogs. Am J Physiol 209:1012-1024, 1965. 42. Bunag R, Page I, McCubbin J: Neural stimulation on release of renin. Circ Res 19:851-858, 1966.Crossref 43. Bunag R, Page I, McCubbin J: Influence of dietary sodium on stimuli causing renal release. Am J Physiol 211:1383-1386, 1966. 44. Johnson J, Davis J, Witty R: Effects of catecholamines and renal nerve stimulation on renin release in the non-filtering kidney. Circ Res 29:646-653, 1971.Crossref 45. Barajas L: The innervation of the juxtaglomerular apparatus: Electron microscopic study of the innervation of the glomerular arterioles. Lab Invest 13:916-929, 1964. 46. Winer N, et al: Adrenergic receptor mediation of renin secretion. J Clin Endocrinol Metab 29:1168-1175, 1970.Crossref 47. Winer N, Chokshi S, Walkenhorst W: Effects of cyclic AMP, sympathomimetic amines and adrenergic receptor antagonists on renin secretion. Circ Res 29:239-248, 1971.Crossref 48. Assaykeen P, et al: Effect of alphaand beta-adrenergic blocking agents on the renin response to hypoglycemia and epinephrine in dogs. Endocrinology 87:1318-1322, 1970.Crossref 49. Otsuka K, et al: Effect of hypoglycemia on plasma renin activity in dogs. Endocrinology 87:1306-1317, 1970.Crossref 50. Reid I, Schrier R, Earley L: An effect of extrarenal beta adrenergic stimulation on the release of renin. J Clin Invest 51:1861-1869, 1972.Crossref 51. Veyrat R, et al: Inhibition of renin by potassium in man. Acta Endocrinol 119( (suppl) ):86-89, 1967. 52. Bull M, et al: The control of renin and aldosterone secretion, influence of sodium and potassium balance and changes in blood volume. J Clin Invest 45:992-993, 1966. 53. Vander A: Direct effect of potassium on renin secretion and renal function. Am J Physiol 219:455-459, 1970. 54. Abbrecht P, Vander A: Effects of chronic potassium deficiency on plasma renin activity. J Clin Invest 49:1510-1516, 1970.Crossref 55. Sealey J, et al: Potassium balance in the control of renin secretion. J Clin Invest 49:2119-2127, 1970.Crossref 56. Brunner H, et al: The influence of potassium administration and of potassium deprivation on plasma renin in normal and hypertensive subjects. J Clin Invest 49:2128-2138, 1970.Crossref 57. Shade R, et al: Effects of renal intraarterial infusion of sodium and potassium on renin secretion in the non-filtering kidney, abstracted. Proc Am Soc Nephrol 5:71, 1971. 58. Brandis M, Keyes J, Windhager E: Potassium-induced inhibition of proximal tubular fluid reabsorption in rats. Am J Physiol 222:421-427, 1972. 59. Schneider E, et al: The effect of potassium infusion on proximal sodium reabsorption and renin release in the dog. Kidney Int 2:197-202, 1972.Crossref 60. Wright F, et al: Potassium secretion by distal tubule after potassium adaptation. Am J Physiol 221:437-438, 1971. 61. Vander A, Geelhoed G: Inhibition of renin secretion by angiotensin II. Proc Soc Exp Biol Med 120:399-403, 1965.Crossref 62. Bonjour J, Malvin R: Stimulation of ADH release by the renin-angiotensin system. Am J Physiol 218:1555-1559, 1970. 63. Brown J, et al: Renin and angiotensin: A survey of some aspects. Postgrad Med J 42:153-176, 1966.Crossref 64. Tagawa H, et al: Inhibition of renin secretion by vasopressin in unanesthetized sodium-deprived dogs. Am J Physiol 220:949-951, 1971. 65. Ganong W: Effects of sympathetic activity and ACTH on renin and aldosterone secretion , in Genest J, Koiw E (eds): Hypertension '72 . Berlin, Springer-Verlag, 1972, pp 4-14. 66. Yamamoto K, et al: Control of renin secretion in the anesthetized dog: II. Relationship between renin secretion, plasma sodium concentration and GFR in the perfused kidney. Jap Circ J 33:593-600, 1969.Crossref 67. Thurau K, Schnermann J: Die Natriumkonzentration an den Maculadensa-Zellen als regulierender Faktor fur das Glomerulumfiltrat (Mikropunktionsversuche). Klin Wochenschr 43:410-414, 1965.Crossref 68. Cortney M, Nagel W, Thurau K: A micropuncture study of the relationship between flow rates with the loop of Henle and sodium concentration in the early distal tubule. Pfluegers Arch 287:286-295, 1966.Crossref 69. Schnermann J: Microperfusion study of single short loops in Henle in rat kidney. Pfluegers Arch 300:255-282, 1968.Crossref 70. Schnermann J, et al: Regulation of superficial nephron filtration rate by tubulo-glomerular feedback. Pfluegers Arch 318:147-175, 1970.Crossref 71. Abe Y, Dixon F, McNay J: Dissociation between autoregulation of renal blood flow and glomerular filtration rate. Am J Physiol 219:986-993, 1970. 72. Morgan T: A microperfusion study of influence of macula densa on glomerular filtration rate. Am J Physiol 220:186-190, 1971. 73. Morgan T: Control of renal blood flow at the individual nephron level, Abstracts of the Plenary Sessions and Symposia. Read before the Fifth International Congress of Nephrology, Mexico City, 1972, p 67. 74. Hierholzer K, Butz R, Lichtenstein I: Single nephron filtration rate and recording of intratubular pressure, Abstracts of the Plenary Sessions and Symposia. Read before the International Congress of Nephrology, Mexico City, 1972, p 80. 75. Blantz R, et al: Relation of distal tubular sodium chloride delivery and glomerular hydrostatic pressure. Kidney Int 2:22-32, 1972.Crossref 76. Schmid H Jr: Renal autoregulation and renin release during changes in renal perfusion pressure. Am J Physiol 222:1132-1137, 1972. 77. Bailie M, Loutzenhiser R, Moyer S: Relation of renal hemodynamics to angiotensin II in renal hilar lymph of the dog. Am J Physiol 222:1075-1078, 1972. 78. Belleau L, Earley L: Autoregulation of renal blood flow in the presence of angiotensin infusion. Am J Physiol 213:1590-1595, 1967. 79. Gagnon J, et al: Analysis of role of reninangiotensin system and autoregulation of glomerular filtration. Am J Physiol 219:491-496, 1970. 80. Bastron R, Kaloyanides G, DiBona G: Effect of renin depletion on autoregulation of renal blood flow, Abstracts of the Plenary Sessions and Symposia. Read before the Fifth International Congress of Nephrology, Mexico City, 1972, p 11. 81. Grandchamp A, et al: Relationship between renin and intrarenal hemodynamics in hemorrhagic hypotension. J Clin Invest 50:970-978, 1971.Crossref 82. Rector J, et al: Effect of hemorrhage and vasopressor agents on distribution of renal blood flow. Am J Physiol 222:1125-1131, 1972. 83. McNay J, Abe Y: Pressure dependent heterogeneity of renal cortical blood flow in dog. Circ Res 27:571-587, 1970.Crossref 84. Stein J, et al: Mechanism of the redistribution of renal cortical blood flow during hemorrhagic hypotension in the dog. J Clin Invest 52:39-47, 1973.Crossref 85. Stein J, et al: Effect of renal vasodilatation on the distribution of cortical blood flow in the kidney of the dog. J Clin Invest 50:1429-1438, 1971.Crossref 86. Bay W, et al: Redistribution of renal cortical blood flow during elevated ureteral pressure. Am J Physiol 222:33-37, 1972. 87. Stein J, et al: Differences in the effect of furosemide and chlorothiazide on the distribution of renal cortical blood flow in the dog. J Lab Clin Med 79:955-1003, 1972. 88. Stein J, Osgood R, Ferris T: Effect of volume expansion on distribution of glomerular filtrate and renal cortical blood flow in the dog. Am J Physiol 223:984-990, 1972. 89. Brown J, et al: Influence of sodium loading and sodium depletion on plasma renin in man. Lancet 2:278-279, 1963.Crossref 90. Tagawa H, Vander A: Effect of acetylcholine on renin secretion in salt-depleted dogs. Proc Soc Exp Biol Med 132:1087-1090, 1969.Crossref 91. Vane JR, Ng K: Conversion of angiotensin I to angiotensin II. Nature (Lond) 216:762-766, 1967.Crossref 92. Oparil S, Sanders C, Haber E: In vivo and in vitro conversion of angiotensin I to angiotensin II in dog blood. Circ Res 26:591-597, 1970.Crossref 93. Talledo 0, Chesley L, Zuspen F: Renin-angiotensin system in normal and toxemic pregnancies. Am J Obstet Gynecol 100:218-222, 1968. 94. Brunner H, et al: Angiotensin II vascular receptors: Their avidity in relationship to sodium balance, the autonomic nervous system and hypertension. J Clin Invest 51:58-67, 1972.Crossref 95. Tobian L, Binnion J: Artery wall electrolytes in renal and DCA hypertension. J Clin Invest 33:1407-1412, 1954.Crossref 96. Kaplan N, Silah J: The effect of angiotensin II on the blood pressure in humans with hypertensive disease. J Clin Invest 43:659-669, 1964.Crossref 97. Gunnels J, et al: Plasma renin activity in healthy subjects and patients with hypertension. Arch Intern Med 119:232-240, 1967.Crossref 98. Helmer 0, Judson W: Metabolic studies on hypertensive patients with suppressed plasma renin activity not due to hyperaldosteronism. Circulation 38:965-976, 1968.Crossref 99. Laragh J, Sealey J, Brunner H: The control of aldosterone secretion in normal and hypertensive man: Abnormal renin-aldosterone patterns in low renin hypertension. Am J Med 53:649-663, 1972.Crossref 100. Brunner H, et al: Essential hypertension: Renin and aldosterone, heart attack and stroke. N Engl J Med 286:441-449, 1972.Crossref 101. Jose A, Crout J, Kaplan N: Suppressed plasma renin activity in essential hypertension: Roles of plasma volume blood pressure, and sympathetic nervous system. Ann Intern Med 72:9-16, 1970.Crossref 102. Conn J, Cohen E, Ronner D: Suppression of plasma renin activity in primary aldosteronism: Distinguishing primary from secondary aldosteronism in hypertensive disease. JAMA 190:213-221, 1964. 103. Collins R, et al: Abnormally sustained aldosterone secretion during salt loading in patients with various forms of benign hypertension: Relation to plasma renin activity. J Clin Invest 49:1415-1426, 1970.Crossref 104. Spark R, Melby J: Hypertension and low plasma renin activity: Presumptive evidence for mineralcorticoid excess. Ann Intern Med 75:831-836, 1971.Crossref 105. Woods J, et al: Effect of an adrenal inhibitor in hypertensive patients with suppressed renin. Arch Intern Med 123:366-370, 1969.Crossref 106. Melby J, Dale S, Wilson T: 18-Hydroxy-deoxycorticosterone in human hypertension. Circ Res 28( (suppl 2) ):143-150, 1971.Crossref 107. Lowaczynski W, Kuchel O, Genest J: Aldosterone, deoxycorticosterone, and corticosterone metabolism in benign essential hypertension , in Genest J, Koiw E (eds): Hypertension '72 . Berlin, Springer-Verlag, 1972, pp 244-254. 108. McAllister R, et al: Malignant hypertension: Effect of therapy on renin and aldosterone. Circ Res 28( (suppl 2) ):160-173, 1971.Crossref 109. Baer L, et al: Pseudo-primary aldosteronism: An entity distinct from primary aldosteronism. Circ Res 27( (suppl 1) ):203-207, 1970. 110. Russell E, Masi A, Richter E: Adrenal cortical adenoma and hypertension. Medicine 51:211-225, 1972.Crossref 111. Baer L, et al: Pseudo-primary aldosteronism, a variant of low renin, essential hypertension? in Genest J, Koiw E (eds): Hypertension '72 . Berlin, Springer-Verlag, 1972, pp 459-472. 112. Bourgoignie J, et al: Renal venous renin in hypertension. Am J Med 48:332-342, 1970.Crossref 113. Kirkendall W, Fitz A, Lawrence M: Renal hypertension: Diagnosis and surgical treatment. N Engl J Med 286:479-484, 1967.Crossref 114. MacDonald G, et al: Renal clip hypertension in rabbits immunized against angiotensin II. Circ Res 27:197-202, 1970.Crossref 115. Regoli D, et al: Interrelationship of renin content in kidneys and blood pressure in renal hypertensive rats. Arch Int Pharmacodyn 140:416-425, 1962. 116. Gunnells J, et al: Peripheral and renal venous plasma renin activity in hypertension. Ann Intern Med 71:555-575,1969.Crossref 117. McCubbin I, Page I: Renal pressor system and neurogenic control of arterial pressure. Circ Res 12:553-559, 1963.Crossref 118. Brody M, Dorr L, Shaffer R: Reflex vasodilatation and sympathetic transmission in the renal hypertensive dog. Am J Physiol 219:1746-1750, 1970. 119. Brunner H, et al: Hypertension of renal origin: Evidence for two different mechanisms. Science 174:1344-1346, 1971.Crossref 120. Gross F: The renin-angiotensin system and hypertension. Ann Intern Med 75:777-787, 1971.Crossref 121. Warren D, Ferris T: Renin secretion in renal hypertension. Lancet 1:159-163, 1970.Crossref 122. Brown J, et al: Plasma renin concentration and the control of blood pressure in patients on maintenance hemodialysis. Nephron 6:329-349, 1969.Crossref 123. Vertes V, et al: Hypertension in end stage renal disease. N Engl J Med 280:978-981, 1969.Crossref 124. Stokes G, Mani M, Stewart J: Relevance of salt, water and renin to hypertension in chronic renal failure. Br Med J 3:126-129, 1970.Crossref 125. Brown J, et al: Plasma electrolytes, renin and aldosterone in the diagnosis of primary hyperaldosteronism. Lancet 2:55-59, 1968.Crossref 126. Kotchen T, et al: Renin and aldosterone in essential hypertension. Clin Sci 41:321-331, 1971. 127. Conn J, Knopf R, Nesbit R: Clinical characteristics of primary aldosteronism from an analysis of 145 cases. Am J Surg 107:159-170, 1964.Crossref 128. Brown J, et al: Serial estimation of plasma renin concentration during pregnancy and after parturition. J Endocrinol 35:373-378, 1966.Crossref 129. Robb C, et al: Mechanisms regulating the renal excretion of sodium during pregnancy. J Clin Invest 49:871-878, 1970.Crossref 130. Gorden P, Ferris T, Mulrow P: Rabbit uterus as a possible site of renin synthesis. Am J Physiol 212:703-707, 1967. 131. Symonds E, Stanley M, Skinner S: Production of renin by in vitro cultures of human chorion and uterine muscle. Nature (Lond) 217:1152-1154, 1968.Crossref 132. Brown J, et al: The presence of renin in human amniotic fluid. Lancet 2:64-66, 1964.Crossref 133. Van Wagener G, Jenkins R: Experimental examination of factors causing ureteral dilatation of pregnancy. J Urol 42:1010-1018, 1939. 134. Eastman N, (ed): Williams' Textbook of Obstetrics , 14th ed. Appleton-Century-Crofts, 1972. 135. Brown J, et al: Plasma renin concentration in hypertensive disease of pregnancy. Lancet 2:1219-1221, 1965.Crossref 136. Ferris T, et al: Toxemia of pregnancy in sheep: A clinical, physiological and pathological study. J Clin Invest 48:1643-1655, 1969.Crossref 137. Ferris T, Stein J, Kauffman J: Uterine blood flow and uterine renin secretion. J Clin Invest 51:2827-2833, 1972.Crossref 138. Carretero 0, et al: Renin release and the uteroplacental-fetal complex. Am J Physiol 223:561-564, 1972. 139. Assali N, Holm L, Siegal N: Regional blood flow and vascular resistance of the fetus in utero: Action of vasoactive drugs. Am J Obstet Gynecol 83:809-812, 1962. 140. Brown J, et al: Variations in plasma renin concentration in several physiological and pathological states. Can Med Assoc J 90:201-206, 1964. 141. Veyrat R, et al: Measurement of human arterial renin activity in some physiological and pathological states. Can Med Assoc J 90:215-220, 1964. 142. Laragh J: Hormones and the pathogenesis of congestive heart failure: Vasopressin, aldosterone and angiotensin II. Circulation 25:1015-1028, 1962.Crossref 143. Wolff H, et al: Role of aldosterone in edema formation. Ann NY Acad Sci 139:285-294, 1966.Crossref 144. Genest J, et al: Endocrine factors in congestive heart failure. Am J Cardiol 22:35-45, 1968.Crossref 145. Camargo C, et al: Decreased plasma clearance and hepatic extraction of aldosterone in patients with heart failure. J Clin Invest 44:356-365, 1965.Crossref 146. Johnston C, et al: Plasma renin in chronic experimental heart failure and during renal sodium "escape" from mineralocorticoids. Circ Res 22:113-125, 1968.Crossref 147. Davis J, et al: Hypersecretion of aldosterone in dogs with a chronic aorticcaval fistula and high output heart failure. Circ Res 14:471-485, 1964.Crossref 148. Streeten D, Louis L, Conn J: Secondary aldosteronism in idiopathic edema. Trans Assoc Am Physicians 73:227-236, 1960. 149. Luetscher J, et al: Idiopathic edema and increased aldosterone excretion , in Baulieu E, Robel P (eds): International Symposium of Aldosterone . Oxford, England, Blackwell Scientific Publications, 1964. 150. Ferris T, et al: Studies of the mechanism of sodium retention in idiopathic edema. Trans Assoc Am Physicians , to be published. 151. Bartter F, et al: Hyperplasia of the juxtaglomerular complex with hyperaldosteronism and hypokalemic alkalosis. Am J Med 33:811-828, 1962.Crossref 152. Cannon P, et al: Juxtaglomerular cell hyperplasia and secondary hyperaldosteronism (Bartter's Syndrome), A reevaluation of the pathophysiology. Medicine 47:107-131, 1968.Crossref 153. White M: Bartter's syndrome. Arch Intern Med 126:41-47, 1972.Crossref 154. Goodman A, Vagnucci A, Hartroft P: Pathogenesis of Bartter's syndrome. N Engl J Med 281:1435-1439, 1969.Crossref 155. Trygstad C, et al: A sibship with Bartter's syndrome: Failure of total adrenalectomy to correct the potassium wasting. Pediatrics 44:234-242, 1969. 156. Liddle G, Bledsoe R, Coppage W Jr: A familial renal disorder simulating primary aldosteronism but with negligible aldosterone secretion. Trans Assoc Am Physicians 76:199-207, 1963. 157. Robertson P, et al: Hypertension due to a renin secreting renal tumor. Am J Med 43:963-976, 1967.Crossref 158. Conn J, et al: Primary reninism. Arch Intern Med 130:682-696, 1972.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

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Abstract

Abstract Renin plays a significant role in normal and pathophysiologic states. Among the various factors affecting renin secretion are the afferent arteriole acting as a baroreceptor, the macula densa as a sensor of sodium delivery to the distal tubule, and the adrenergic nervous system. There is contrasting evidence for a potential role of intrarenal renin in autoregulating the renal blood flow and glomerular filtration rate. Levels of plasma renin vary with the clinical setting. Emphasis is placed on the role of renin in controlling effective blood volume through its effect on vascular tone and volume by release of angiotensin and aldosterone. References 1. Tigerstedt R, Bergmann PG: Niere und Kreislauf. Skandinav Arch Physiol 8:223-228, 1898.Crossref 2. Goldblatt H, et al: Studies on experimental hypertension: I. The production of persistent elevation of systolic blood-pressure by means of renal ischemia. J Exp Med 59:347-354, 1934.Crossref 3. Braun-Menendez E, et al: The substance causing renal hypertension. J Physiol 98:283-298, 1940. 4. Page IH, Helmer OM: Angiotonin activator, renin and angiotonin-inhibitor and the mechanism of angiotonin tachyphylaxis in normal, hypertensive and nephrectomized animals. J Exp Med 71:495-501, 1940.Crossref 5. Skeggs LT, Kahn JR, Shumway NP: The purification of hypertensin II. J Exp Med 103:301-308, 1956.Crossref 6. Elliott DF, Peart WS: Amino acid sequence in a hypertensin. Nature (Lond) 117:527-528, 1956.Crossref 7. Schwyzer R, et al: Synthese hochwirksamer Dekapeptide mit der Aminosauresequenz des val5-hypertensins I. Helv Chim Acta 41:1273-1276, 1958.Crossref 8. Genest J, et al: Adrenocortical function in essential hypertension , Buchborn C, Bock KD (eds): in Essential Hypertension: An International Symposium . Berlin, Springer-Verlag, 1960, pp 126-146. 9. Laragh JH, et al: Hypotensive agents and pressor substances: The effect of epinephrine, norepinephrine, angiotensin II and others on the secretory rate of aldosterone in man. JAMA 174:234-240, 1960.Crossref 10. Goormaghtigh N: Existence of an endocrine gland in the media of the renal arterial. Proc Soc Exp Biol Med 42:688-689, 1939.Crossref 11. Tobian L, Janecek J, Tomboulian A: Correlation between granulation of juxtaglomerular cells and extractable renin in rats with experimental hypertension. Proc Soc Exp Biol Med 100:94-96, 1959.Crossref 12. Pitcock J, Hartroft P, Newmark L: Increased renal pressor activity (renin) in sodium-deficient rats and correlation with juxtaglomerular granulation. Proc Soc Exp Biol Med 100:868-869, 1959.Crossref 13. Cook W, Pickering G: Location of renin within kidney. J Physiol (Lond) 143:78P-79P, 1958. 14. Bing J, Wiberg B: Localization of renin in kidney. Acta Pathol Microbiol Scand 44:138-142, 1958.Crossref 15. Bing J, Kazimierczak J: Renin content of different parts of periglomerular circumference. Acta Pathol Microbiol Scand 50:1-11, 1960.Crossref 16. Granger P, Dahlheim H, Thurau K: Enzyme activities of the single juxtaglomerular apparatus in the rat kidney. Kidney Int 1:78-88, 1972.Crossref 17. Hartroft P: Juxtaglomerular cells. Circ Res 12:525-530, 1963.Crossref 18. Hartroft P, Sutherland L, Hartroft W: Juxtaglomerular cells as the source of renin: Further studies with the fluorescent antibody technique and the effect of passive transfer of anti-renin. Can Med Assoc J 90:163-166, 1964. 19. Robertson A, et al: Renin production by organ culture of renal cortex. Science 149:650-651, 1965.Crossref 20. Robertson A, et al: Production of renin by human juxtaglomerular cells in vitro. Circ Res 18( (suppl) ):131-142, 1966.Crossref 21. Huidobro F, Braun-Menendez E: The secretion of renin by the intact kidney. Am J Physiol 137:47-55, 1942. 22. Skinner S, McCubbin J, Page I: Control of renin secretion. Circ Res 15:64-76, 1964.Crossref 23. Spath J Jr, et al: Effect of acute local renal hypoxia on renin activity in renal venous blood. Proc Soc Exp Biol Med 137:484-488, 1971.Crossref 24. Tobian L, Tomboulian A, Janecek J: Effect of high perfusion pressures on the granulation of juxtaglomerular cells in an isolated kidney. J Clin Invest 38:605-610, 1959.Crossref 25. Vander A, Miller R: Control of renin secretion in the anesthetized dog. Am J Physiol 207:537-546, 1964. 26. Blaine E, Davis J, Witty R: Renin release after hemorrhage and after suprarenal aortic constriction in dogs without sodium delivery to the macula densa. Circ Res 27:1081-1089, 1970.Crossref 27. Blaine E, Davis J: Evidence for a renal vascular mechanism in renin release: New observations with graded stimulation by aortic constriction. Circ Res 18 ( (suppl) ):118-126, 1971. 28. 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Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1973

References

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