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A study of the renin-angiotensin-aldosterone system in severe infantile malnutrition

C M Godard, M Muñoz, M A Sanchez

    The International Journal of Pediatric Nephrology
    |January 1, 1986
    PubMed

    Insights

    Severe malnutrition in children significantly elevates plasma renin activity, which normalizes with dietary sodium repletion. This suggests a link between the renin-angiotensin system and kidney function in malnourished infants.

    Area of Science:

    • Pediatric Endocrinology
    • Renal Physiology
    • Nutritional Science

    Background:

    • Severe malnutrition, specifically marasmic kwashiorkor, presents complex physiological challenges in children.
    • The renin-angiotensin-aldosterone system (RAAS) plays a crucial role in fluid and electrolyte balance.
    • Understanding RAAS function in malnutrition is vital for managing associated renal complications.

    Purpose of the Study:

    • To investigate plasma renin activity, renin substrate, and aldosterone levels in children with severe malnutrition.
    • To assess the impact of sodium repletion on these hormonal parameters.
    • To explore correlations between RAAS components, urinary sodium excretion, and serum potassium.

    Main Methods:

    • Plasma samples were collected from 17 children (12-28 months) with severe malnutrition.
    • Hormone levels (renin activity, renin substrate, aldosterone) were measured at admission and after sodium repletion.
    • Urinary sodium excretion and serum potassium levels were also analyzed.

    Main Results:

    • Plasma renin activity was markedly elevated upon admission (median 29.0 ng/ml/hr) and decreased significantly after sodium repletion (9.9 ng/ml/hr).
    • Plasma renin activity showed a negative correlation with urinary sodium excretion.
    • Plasma renin substrate and aldosterone concentrations were within normal ranges, with aldosterone positively correlating with serum potassium.

    Conclusions:

    • The renin-angiotensin system is hyperactive in children with severe malnutrition.
    • Dietary sodium repletion effectively modulates plasma renin activity.
    • RAAS hyperactivity may contribute to renal dysfunction observed in severe malnutrition.

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