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Renin angiotensin aldosterone

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https://www.readbyqxmd.com/read/28449402/postprandial-renal-haemodynamic-effect-of-lixisenatide-versus-once-daily-insulin-glulisine-in-type-2-diabetes-patients-on-insulin-glargine-an-8-week-randomised-open-label-trial
#1
Lennart Tonneijck, Marcel H A Muskiet, Mark M Smits, Trynke Hoekstra, Mark H H Kramer, A H Jan Danser, Michaela Diamant, Jaap A Joles, Daniël H van Raalte
AIMS: To determine whether lixisenatide, a prandial short-acting glucagon-like peptide receptor agonist (GLP-1RA), ameliorates postprandial glomerular hyperfiltration in type 2 diabetes mellitus (T2DM)-patients compared to insulin-glulisine (iGlu) . METHODS: Postprandial renal haemodynamic effects of 8-week treatment with lixisenatide 20 µg versus once-daily titrated iGlu were measured in 35 overweight T2DM-patients inadequately controlled on insulin-glargine, with or without metformin (mean±SD age 62 ± 7years, HbA1c 8...
April 27, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28449154/dual-raas-blockade-with-aliskiren-in-patients-with-severely-impaired-chronic-kidney-disease
#2
Franz Maximilian Rasche, Claudia Joel, Thomas Ebert, Thomas Frese, Filip Barinka, Volker Busch, Wilma Gertrud Rasche, Tom H Lindner, Jochen Schneider, Stephan Schiekofer
Dual renin-angiotensin-aldosterone blockade (dRAASb) is purposed in the prevention of the cardiorenal syndrome (CRS). However, all attempts with dRAASb even in patients with moderate impaired chronic kidney disease (CKD) were terminated due to the typical severe adverse events (SAE), e. g., hyperkalemia and rise of serum creatinine. The aim of our study with the direct renin inhibitor aliskiren was to evaluate the effect of dRAASb with a washout phase in patients with severely advanced CKD. We have studied 45 patients (G3b to 4, A2 and >A3; median glomerular filtration rate (GFR) CKD-EPI 31 (23-40) ml/min per 1...
April 27, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28436256/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#3
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28428753/a-clinical-perspective-of-anti-fibrotic-therapies-for-cardiovascular-disease
#4
REVIEW
Lu Fang, Andrew J Murphy, Anthony M Dart
Cardiac fibrosis are central to various cardiovascular diseases. Research on the mechanisms and therapeutic targets for cardiac fibrosis has advanced greatly in recent years. However, while many anti-fibrotic treatments have been studied in animal models and seem promising, translation of experimental findings into human patients has been rather limited. Thus, several potential new treatments which have shown to reduce cardiac fibrosis in animal models have either not been tested in humans or proved to be disappointing in clinical trials...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28426518/pathophysiologic-insight-into-mesoamerican-nephropathy
#5
Magdalena Madero, Fernando E García-Arroyo, Laura-Gabriela Sánchez-Lozada
PURPOSE OF REVIEW: Mesoamerican nephropathy (MeN) is an emerging pathophysiological entity of Chronic kidney desease (CKD) not related to traditional risk factors (diabetes and hypertension) that have caused thousands of deaths in Central America, mainly in sugarcane workers. The focus of this review is to discuss the risk factors and probable mechanisms involved in the initiation and progression of this devastating disease. RECENT FINDINGS: Frequent episodes of subclinical Acute kidney injury caused by repetitive heat stress, dehydration, and strenuous work have been regarded as the main risk factors for MeN...
April 19, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28425437/are-genetic-polymorphisms-in-the-renin-angiotensin-aldosterone-system-associated-with-essential-hypertension-evidence-from-genome-wide-association-studies
#6
REVIEW
L-D Ji, J-Y Li, B-B Yao, X-B Cai, Q-J Shen, J Xu
In candidate gene era, dozens of single-nucleotide polymorphisms (SNPs) within renin-angiotensin-aldosterone system (RAAS) have been reported to be significantly associated with hypertension. However, the unbiased genome-wide association studies (GWAS) rarely identified the SNPs within RAAS were associated with hypertension or blood pressure (BP) traits. In order to figure out whether genetic polymorphisms of RAAS are really associated with hypertension, we systemically searched the GWAS Catalogue and identified all the known RAAS genes and relevant diseases/traits...
April 20, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28423630/insufficient-hypothalamic-angiotensin-converting-enzyme-2-is-associated-with-hypertension-in-shr-rats
#7
Kun Wang, Yuanyuan Xu, Weiwei Yang, Yuanshu Zhang
Angiotensin-Converting Enzyme 2 (ACE2) is a key enzyme in the renin-angiotensin system (RAS), which is implicated in the pathogenesis of hypertension and other cardiovascular diseases. In this study we investigated the expression of ACE2 in the hypothalamus and pituitary tissues and its relationship to hypertension by comparing them in male WKY and SHR rats. We observed that the plasma levels of corticotrophin releasing hormone (CRH), adrenocorticotropic hormone (ACTH) and aldosterone (ALD) were all lower in SHR than WKY rats (P<0...
March 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28422842/the-role-of-renoscintigraphy-and-surgery-in-the-management-of-page-kidney-a-case-report
#8
Yu-Li Chiu, Chin Hu, Sin-Di Lee, Po-Yin Chen, Cheng-Pin Wang
RATIONALE: Page kidney is an uncommon condition that hypertension occurs secondary to microvascular ischemia and alternation of small-vessel hemodynamics due to external compression of renal parenchyma and activation of the renin-angiotensin-aldosterone system. There are no specific guidelines for the management of Page kidney in the literatures. PATIENT CONCERNS: A 17-year-old teenager who had Fontan procedure for tricuspid and pulmonary atresia in early childhood suffered from sudden onset of severe left flank pain during cardiac catheterization procedure...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28417649/internal-dysregulation-of-the-renin-system-in-patients-with-stable-liver-cirrhosis
#9
Annette Dam Fialla, Helle C Thiesson, Peter Bie, Ove B Schaffalitzky de Muckadell, Aleksander Krag
Sodium retention in cirrhosis is associated with changes in the renin-angiotensin-aldosterone system (RAAS), the sympathetic nervous system (SNS), and the glomerular filtration rate (GFR). We hypothesized that in cirrhosis the acute reactions of RAAS and SNS to volume expansion are qualitatively intact, but occurring from elevated baseline levels. Acute cardiovascular, neurohumoral and renal responses to central blood volume changes were studied in cirrhotic patients and healthy controls. In patients, baseline plasma renin concentration (PRC) was elevated 5-fold compared to controls (p < ...
April 18, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28417590/calcitonin-gene-related-peptide-cgrp-a-novel-target-for-alzheimer-s-disease
#10
REVIEW
Yogendra Singh, Gaurav Gupta, Birendra Shrivastava, Rajiv Dahiya, Juhi Tiwari, Madhu Ashwathanarayana, Rakesh Kumar Sharma, Mohit Agrawal, Anurag Mishra, Kamal Dua
Alzheimer's disease (AD) is leading cause of death among older characterized by neurofibrillary tangles, oxidative stress, progressive neuronal deficits, and increased levels of amyloid-β (Aβ) peptides. Cholinergic treatment could be the best suitable physiological therapy for AD. Calcitonin gene-related peptide (CGRP) is a thirty-seven-amino acid regulatory neuropeptide resulting from different merging of the CGRP gene, which also includes adrenomedullin, amylin, calcitonin, intermedin, and calcitonin receptor-stimulating peptide...
April 17, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/28416004/clinical-study-of-children-with-takayasu-arteritis-a-retrospective-study-from-a-single-center-in-china
#11
Ye Feng, Xuemei Tang, Mingyue Liu, Juan Zhou, Xiaodong Zhao, Qiu Li
BACKGROUND: Delayed diagnosis of childhood Takayasu arteritis (TA) is common due to its atypical symptoms. The objective of the present study was to summarize the clinical features of childhood TA to raise awareness and improve management. METHODS: Eleven children diagnosed with TA at our hospital were enrolled. Clinical information, diagnosis, treatment, and outcome were then examined retrospectively. The Pediatric Vasculitis Activity Score (PVAS) and the Indian Takayasu Clinical Activity Score (ITAS2010) were used to assess disease activity...
April 17, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28414295/high-salt-intake-reprioritizes-osmolyte-and-energy-metabolism-for-body-fluid-conservation
#12
Kento Kitada, Steffen Daub, Yahua Zhang, Janet D Klein, Daisuke Nakano, Tetyana Pedchenko, Louise Lantier, Lauren M LaRocque, Adriana Marton, Patrick Neubert, Agnes Schröder, Natalia Rakova, Jonathan Jantsch, Anna E Dikalova, Sergey I Dikalov, David G Harrison, Dominik N Müller, Akira Nishiyama, Manfred Rauh, Raymond C Harris, Friedrich C Luft, David H Wassermann, Jeff M Sands, Jens Titze
Natriuretic regulation of extracellular fluid volume homeostasis includes suppression of the renin-angiotensin-aldosterone system, pressure natriuresis, and reduced renal nerve activity, actions that concomitantly increase urinary Na+ excretion and lead to increased urine volume. The resulting natriuresis-driven diuretic water loss is assumed to control the extracellular volume. Here, we have demonstrated that urine concentration, and therefore regulation of water conservation, is an important control system for urine formation and extracellular volume homeostasis in mice and humans across various levels of salt intake...
April 17, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28413967/uncontrolled-hypertension-and-oncology-clinical-%C3%AE-ips
#13
Rigas G Kalaitzidis, Moses S Elisaf
Angiogenesis is fundamental for tumour development and progression. Thus, anti-angiogenic agents have been developed and are mainly vascular endothelial growth factor (VEGF) pathway inhibitors. However, these agents commonly exhibit cardiac and renal toxicity, proteinuria and hypertension (HT). In fact, with the use of anti-angiogenic agents a rapiddose-dependent increaseof blood pressure (BP) is observed. Thepossible mechanisms of VEGF inhibitors-induced HTinclude systemic endothelial dysfunction, renal impairment as well as vascular micro- and macroangiopathy...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413612/advances-in-understanding-the-renin-angiotensin-aldosterone-system-raas-in-blood-pressure-control-and-recent-pivotal-trials-of-raas-blockade-in-heart-failure-and-diabetic-nephropathy
#14
REVIEW
Lama Ghazi, Paul Drawz
The renin-angiotensin-aldosterone system (RAAS) plays a fundamental role in the physiology of blood pressure control and the pathophysiology of hypertension (HTN) with effects on vascular tone, sodium retention, oxidative stress, fibrosis, sympathetic tone, and inflammation. Fortunately, RAAS blocking agents have been available to treat HTN since the 1970s and newer medications are being developed. In this review, we will (1) examine new anti-hypertensive medications affecting the RAAS, (2) evaluate recent studies that help provide a better understanding of which patients may be more likely to benefit from RAAS blockade, and (3) review three recent pivotal randomized trials that involve newer RAAS blocking agents and inform clinical practice...
2017: F1000Research
https://www.readbyqxmd.com/read/28411317/race-obesity-and-the-renin-angiotensin-aldosterone-system-treatment-response-in-children-with-primary-hypertension
#15
Andrew M South, Lester Arguelles, Gal Finer, Craig B Langman
BACKGROUND: Pediatric primary hypertension (HTN) is increasingly recognized, but the effect of patient characteristics such as obesity and race on treatment outcomes is not well described. The renin-angiotensin-aldosterone system (RAAS) may also contribute to HTN. We hypothesized patient parameters of these factors, including baseline RAAS, influence blood pressure (BP) response to pharmacological treatment in HTN. METHODS: This was a retrospective cohort of 102 consecutive patients with HTN...
April 14, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28411074/low-dose-sustained-release-deoxycorticosterone-acetate-induced-hypertension-in-bama-miniature-pigs-for-renal-sympathetic-nerve-denervation
#16
Wenzheng Han, Weiyi Fang, Qian Gan, Shaofeng Guan, Yanjie Li, Ming Wang, Kaizheng Gong, Xinkai Qu
Recently, the effectiveness of renal sympathetic nerve denervation for treatment of hypertension has been doubted after SYMPLICITY HTN-3 trial. An ideal animal model is still unavailable for preclinical study about catheter-based renal sympathetic nerve denervation for treatment of hypertension. Traditional high-dose deoxycorticosterone acetate (DOCA)-induced hypertension pig model has some problems due to extensive end-organ damage. Based on the similarity in the anatomic characteristics of renal artery between pigs and humans, this study was undertaken to establish a low-dose sustained-release DOCA-induced hypertension model in pigs...
March 2, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28405801/urine-exosomes-from-healthy-and-hypertensive-pregnancies-display-elevated-level-of-%C3%AE-subunit-and-cleaved-%C3%AE-and-%C3%AE-subunits-of-the-epithelial-sodium-channel-enac
#17
Maria R Nielsen, Britta Frederiksen-Møller, Rikke Zachar, Jan S Jørgensen, Mie R Hansen, Rikke Ydegaard, Per Svenningsen, Kristian Buhl, Boye L Jensen
Preeclampsia is characterized by hypertension, proteinuria, suppression of plasma renin-angiotensin-aldosterone, and impaired urine sodium excretion. Aberrantly filtered plasmin in urine may activate proteolytically the γ-subunit of the epithelial sodium channel (ENaC) and promote Na(+) reabsorption and urine K(+) loss. Plasma and urine was sampled from patients with preeclampsia, healthy pregnant controls and non-pregnant women, and from patients with nephrostomy catheters. Aldosterone concentration, urine plasminogen, and protein were determined...
April 12, 2017: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/28404736/the-link-between-adipose-tissue-renin-angiotensin-aldosterone-system-signaling-and-obesity-associated-hypertension
#18
REVIEW
Monica T J Schütten, Alfons J H M Houben, Peter W de Leeuw, Coen D A Stehouwer
Obese individuals frequently develop hypertension, which is for an important part attributable to renin-angiotensin-aldosterone system (RAAS) overactivity. This review summarizes preclinical and clinical evidence on the involvement of dysfunctional adipose tissue in RAAS activation and on the renal, central, and vascular mechanisms linking RAAS components to obesity-associated hypertension.
May 2017: Physiology
https://www.readbyqxmd.com/read/28395009/an-overview-of-the-inflammatory-signalling-mechanisms-in-the-myocardium-underlying-the-development-of-diabetic-cardiomyopathy
#19
Giacomo Frati, Leonardo Schirone, Isotta Chimenti, Derek Yee, Giuseppe Biondi-Zoccai, Massimo Volpe, Sebastiano Sciarretta
Heart failure is a highly morbid and mortal clinical condition that represents the last stage of most cardiovascular disorders. Diabetes is strongly associated with an increased incidence of heart failure and directly promotes cardiac hypertrophy, fibrosis, and apoptosis. These changes, in turn, contribute to the development of ventricular dysfunction. The clinical condition associated with the spectrum of cardiac abnormalities induced by diabetes is termed diabetic cardiomyopathy. Myocardial inflammation has recently emerged as a pathophysiological process contributing to cardiac hypertrophy, fibrosis, and dysfunction in cardiac diseases...
March 15, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28386567/mechanistic-insight-and-management-of-diabetic-nephropathy-recent-progress-and-future-perspective
#20
REVIEW
Rui Xue, Dingkun Gui, Liyang Zheng, Ruonan Zhai, Feng Wang, Niansong Wang
Diabetic nephropathy (DN) is the most serious microvascular complication of diabetes and the largest single cause of end-stage renal disease (ESRD) in many developed countries. DN is also associated with an increased cardiovascular mortality. It occurs as a result of interaction between both genetic and environmental factors. Hyperglycemia, hypertension, and genetic predisposition are the major risk factors. However, the exact mechanisms of DN are unclear. Despite the benefits derived from strict control of glucose and blood pressure, as well as inhibition of renin-angiotensin-aldosterone system, many patients continue to enter into ESRD...
2017: Journal of Diabetes Research
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