title: Normotensive hyperreninemia in systemic lupus erythematosus. An indicator of tubular dysfunction.
abstract: High plasma renin activity (PRA) was found in 16 of 42 randomly selected nonuremic systemic lupus erythematosus (SLE) patients. Mild hypertension was present in 3 of the 16.6 high-PRA and 10 normal-PRA patients were admitted to a metabolic ward. Salt restriction produced a disproportionate rise in both PRA and aldosterone, a decrease in glomerular filtration rate (GFR) and a slightly greater negative sodium balance in the group with high PRA. Potassium excretion was less than intake in both groups. Balance studies were performed in 6 additional high-PRA patients before and during indomethacin administration (150 mg/24 h). PRA and aldosterone were markedly suppressed by indomethacin. UnaV was significantly greater than in the control period despite of the 28% reduction in GFR. These results suggest that high PRA is secondary to impaired distal tubular sodium reabsorption. Such a defect could be responsible for the relatively low frequency of hypertension in lupus nephritis.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000378:metabolism; D001794:Blood Pressure; D001835:Body Weight; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007213:Indomethacin / Q000494:pharmacology; D007684:Kidney Tubules / Q000503:physiopathology*; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000473:pathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D011188:Potassium / Q000652:urine; D012083:Renin / Q000097:blood*; D012964:Sodium / Q000378:metabolism
chemical_list: D000450:Aldosterone; D012964:Sodium; D012083:Renin; D011188:Potassium; D007213:Indomethacin