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Renin secretion in advanced diabetic nephropathy.
Scandinavian Journal of Urology and Nephrology. Supplementum
|January 1, 1984
Summary
Patients with diabetic nephropathy (DN) show higher plasma renin activity (PRA) responses to captopril than controls, indicating preserved renin secretion capacity despite potential renal baroreceptor and sympathetic innervation issues.
Area of Science:
- Nephrology
- Endocrinology
- Hypertension
Background:
- Diabetic nephropathy (DN) is often associated with low basal and stimulated plasma renin activity (PRA).
- Understanding the renin-angiotensin-system (RAS) in DN is crucial for managing hypertension and renal complications.
Purpose of the Study:
- To investigate plasma renin activity (PRA) levels and responses to stimuli in patients with diabetic nephropathy (DN).
- To explore the implications of PRA responses for renal function and sympathetic innervation in DN.
Main Methods:
- Measured PRA before and after captopril stimulation in 28 DN patients and 25 controls.
- Assessed PRA response to dihydralazine in 19 DN patients.
- Compared renal function and blood pressure changes between groups.
Main Results:
- PRA levels and captopril-stimulated increases were significantly higher in the DN group compared to controls.
- PRA response to dihydralazine was blunted in DN patients despite blood pressure reduction.
- Renal function impairment was similar between groups, with most patients on furosemide.
Conclusions:
- Patients with DN exhibit preserved renin secretion capacity, challenging previous notions of low PRA.
- Blunted PRA response to dihydralazine suggests selective lesions in sympathetic innervation and renal baroreceptor function in DN.
- Overhydration may explain previously reported low PRA in DN; the renin-angiotensin-system plays a role in DN-associated hypertension.