The renin-aldosterone system and renal function in kidney transplantation.
Six renal transplant recipients, six uninephrectomized patients and six normal subjects were subjected to the physiological manoeuvre of head-out water immersion (WI), in order to compare changes in electrolyte and humoral responses known to occur in healthy individuals with those arising as a result of renal denervation in the transplant recipients. The denervated, transplanted kidneys of the six patients were able to maintain a sodium excretory response to WI identical to that obtained in the controls (from 121 +/- 18 to 236 +/- 29 mumol/min, p < 0.005 vs 113 +/- 17 to 213 +/- 18 mumol/min, p < 0.005, respectively). Kidney transplant patients were also characterized by a preserved suppression of renin-aldosterone system (from 1.2 +/- 0.2 to 0.5 +/- 0.1 ng/ml/h, p < 0.03 and 12 +/- 1.0 to 7.0 +/- 1.0 ng/dl, p < 0.005, respectively) and stimulation of atrial natriuretic peptide (from 84 +/- 15 to 153 +/- 25 pg/ml, p < 0.05) to central hypervolemia by water immersion. The present study, while confirming the ability of the denervated kidney to handle sodium normally, also suggests that atrial natriuretic peptide could assume a crucial role in regulating renin secretion.
Coruzzi
P
P
Istituto di Semeiotica Medica, University of Parma, Italy.
Musiari
L
L
Mossini
G L
GL
Ceriati
R
R
Mutti
A
A
D000328:Adult; D000450:Aldosterone / Q000502:physiology*; D009320:Atrial Natriuretic Factor / Q000502:physiology; D005260:Female; D006801:Humans; D007668:Kidney / Q000294:innervation / Q000502:physiology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012083:Renin / Q000502:physiology*; D012964:Sodium / Q000652:urine
D000450:Aldosterone; D009320:Atrial Natriuretic Factor; D012964:Sodium; D012083:Renin