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Influence of crying on plasma renin activity and aldosterone concentration
K Shimomura1, J Fukushige, K Ueda
1Department of Paediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Insights
Infant crying during venipuncture elevates plasma renin activity (PRA) and plasma aldosterone concentration (PAC). Both hormones increased over time, with PRA showing a more significant rise than PAC.
Area of Science:
- Pediatrics
- Endocrinology
- Physiology
Background:
- Venipuncture in infants and toddlers commonly induces crying.
- Crying is a stressor known to affect hormonal levels, specifically plasma renin activity (PRA) and plasma aldosterone concentration (PAC).
- Precise data on the temporal relationship between crying-induced stress and these hormonal changes in young children is limited.
Purpose of the Study:
- To quantify the changes in PRA and PAC levels in infants and toddlers during and after venipuncture-induced crying.
- To establish the time course of PRA and PAC elevation in response to acute stress in this age group.
Main Methods:
- Blood samples were collected from 30 infants and toddlers (aged 1-30 months) within 1 minute of crying onset due to venipuncture.
- Subsequent blood samples were taken at 3 and 5 minutes after crying continued.
- Levels of PRA and PAC were measured in all collected samples.
Main Results:
- Plasma renin activity (PRA) levels increased from 4.0 ± 1.8 ng/ml/hr at 1 minute to 7.8 ± 4.2 ng/ml/hr at 5 minutes.
- Plasma aldosterone concentration (PAC) levels rose from 210 ± 110 pg/ml at 1 minute to 269 ± 145 pg/ml at 5 minutes.
- Both PRA and PAC showed a time-dependent increase, with PRA exhibiting a more pronounced elevation compared to PAC.
Conclusions:
- Venipuncture-induced crying in infants and toddlers leads to significant increases in PRA and PAC.
- The renin-angiotensin-aldosterone system is activated by acute stress in young children.
- PRA demonstrates a more sensitive response to short-term crying stress than PAC in this population.
Abstract:
Infants and toddlers often start crying at venopuncture and the stress of crying has been known to increase the levels of plasma renin activity (PRA) and plasma aldosterone concentration (PAC), but no precise information is available. We measured the levels of PRA and PAC in blood samples taken from 30 infants and toddlers within 1 min after the onset of crying, as induced by venopuncture, and 3 and 5 min after continuation of crying (PRA1.0, PRA3.0, PRA5.0, and PAC1.0, PAC3.0, PAC5.0). The age of these subjects ranged from 1 to 30 months (median 16 months). PRA1.0, PRA3.0 and PRA5.0 were 4.0 +/- 1.8 ng/ml per hour, 5.5 +/- 2.7 ng/ml per hour, and 7.8 +/- 4.2 ng/ml per hour, respectively. PAC1.0, PAC3.0 and PAC5.0 were 210 +/- 110 pg/ml, 231 +/- 118 pg/ml and 269 +/- 145 pg/ml, respectively. Both PRA and PAC increased with elapsing time. The increase in PRA was marked after a short episode of crying, but that in PAC was of a mild degree.