[Changes in the renin-angiotensin-aldosterone system in glomerulonephritis]

The performance of the renin-angiotensin-aldosterone system and water-salt balance was studied in 69 patients with various patterns (both clinical and morphological) of glomerulonephritis. The author revealed that the levels of total and nonactive renin in the plasma of patients prone to membranous proliferative nephritis were higher than both in controls and in the patients with mesangial proliferative disease. Though there was no difference in the levels of active renin. Besides, it was stated that the renin-angiotensin system more strongly governed the pathogenesis of arterial hypertension in patients with membranous proliferative nephritis than in those who suffered from mesangial proliferative patterns of the disease. As the blood pressure levels turned to be dependent both on the levels of plasma and total renin the author established the existence of a mixed mechanism of hypertension occurrence in the patients with glomerulonephritis. Conversion of the nonactive part of renin into the active one promoted the rise of blood pressure. Therefore, in this case the increased levels of the renin nonactive fraction could be regarded as a risk factor for the occurrence of the hypertensive syndrome. The patients with glomerulonephritis enrolled in the study and 15 controls demonstrated a significant feedback correlation between the levels of total and nonactive renin as well as between the exchangeable sodium and its extracellular levels; the degree of correlation in hypertensive patients varied. It was demonstrated that hyperkalemia could be a reason for an increase in aldosterone levels observed in patients with renal failure.(ABSTRACT TRUNCATED AT 250 WORDS)