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Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

421
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
421
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

597
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
597
Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors01:30

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors

618
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
618
Hormonal Regulation01:33

Hormonal Regulation

33.1K
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
33.1K
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

84
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
84
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

363
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
363

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Related Experiment Video

Updated: Jun 25, 2025

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock
07:48

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock

Published on: October 28, 2022

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Renin in critically ill patients.

Yuki Kotani1, Mark Chappell2, Giovanni Landoni3,4

  • 1Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan.

Annals of Intensive Care
|May 22, 2024
PubMed
Summary

Elevated renin levels in critically ill patients may indicate disease severity and predict poor outcomes, outperforming lactate for mortality prediction. Renin shows promise as a biomarker for guiding angiotensin II treatment in shock resuscitation.

Keywords:
Angiotensin IIBiomarkersCritical illnessIntensive care unitsMortalityReninShock

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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
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Last Updated: Jun 25, 2025

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Normothermic Cardiac Arrest and Cardiopulmonary Resuscitation: A Mouse Model of Ischemia-Reperfusion Injury
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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
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Area of Science:

  • Critical care medicine
  • Renal physiology
  • Hemodynamic regulation

Background:

  • The renin-angiotensin system (RAS) is crucial for homeostasis but its role in critically ill hypotensive patients is understudied.
  • Angiotensin II (Ang II) approval for shock treatment has increased interest in RAS in critical care.
  • Renin, the system's initiator, is released in response to hypotension and may reflect disease severity.

Purpose of the Study:

  • To review the current understanding of renin as a biomarker in critically ill patients.
  • To explore future directions for renin's clinical application in resuscitation.
  • To discuss renin's prognostic accuracy and potential for guiding Ang II therapy.

Main Methods:

  • This narrative review synthesizes existing literature on renin in critically ill populations.
  • It examines studies on renin's prognostic value and its association with treatment response.
  • The review considers the limitations and future needs for renin assay development.

Main Results:

  • Elevated renin levels correlate with disease severity and predict poor outcomes in critically ill patients.
  • Renin has shown superior prognostic accuracy compared to lactate for mortality prediction.
  • Renin reduction can assess Ang II treatment effectiveness and may identify patients benefiting from Ang II.

Conclusions:

  • Renin is a promising biomarker for prognostication and guiding therapy in critically ill hypotensive patients.
  • Further prospective studies are needed to confirm renin's utility.
  • Development of rapid, point-of-care renin assays is essential for clinical integration.