Role of the renin-angiotensin system in post-transplantation hypertension in patients with multiple kidneys.
To define the role of the renin-angiotensin system in post-transplantation hypertension we studied 12 hypertensive recipients of renal transplants. The patients received saralasin acetate, an angiotensin II antagonist, while on a normal sodium diet and again after seven days of sodium restriction. In six patients with only one kidney, saralasin did not lower blood pressure on either diet; salt depletion did not lower systolic or diastolic blood pressures. In six patients with more than one kidney, salt depletion also did not lower blood pressure; however, salt depletion plus saralasin lowered their systolic pressures from a mean (+/- S.E.M.) of 146 +/- 9 to 128 +/- 8 mm Hg, and mean diastolic pressures fell from 103 +/- 5 to 89 +/- 5 (P less than 0.001). In four of five patients renal-vein renin activity was greater in one or more host kidneys than in the transplant kidney (or kidneys). Although pre-transplant blood pressure was the same in both groups, post-transplantation hypertension is more likely to be angiotensin II-dependent in patients with more than one kidney.
D000293:Adolescent; D000328:Adult; D000450:Aldosterone / Q000097:blood; D000804:Angiotensin II / Q000037:antagonists & inhibitors / Q000097:blood*; D001794:Blood Pressure / Q000187:drug effects; D004032:Diet; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000517:prevention & control; D007263:Infusions, Parenteral; D007668:Kidney / Q000378:metabolism*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012082:Renal Veins; D012083:Renin / Q000097:blood / Q000378:metabolism*; D012504:Saralasin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D012964:Sodium / Q000378:metabolism; D014184:Transplantation, Homologous
D000804:Angiotensin II; D000450:Aldosterone; D012964:Sodium; D012083:Renin; D012504:Saralasin