Short- and long-term glycaemic control and the state of the renin system in type 1 diabetes mellitus.

Renin system blockade in diabetes exerts a strong positive influence on complications, especially nephropathy. In hyperglycaemic diabetic subjects, however, blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibitors results in a marked rise in plasma renin. We investigated whether glycaemic fluctuations measured in hours, or those measured in weeks by Haemoglobin A(1C) (HbA(1C)) , influenced the plasma renin response to captopril.

Racial differences in renal vascular response to angiotensin blockade with captopril or candesartan.

Objective: We compared the renal vascular response to captopril and candesartan among nondiabetic, normotensive black and white participants to explore angiotensin-converting enzyme-independent generation of angiotensin II.

Methods: Thirteen black individuals and 10 white individuals in low-salt balance were given captopril and candesartan on sequential study days, and the renal plasma flow responses to these agents were measured.

Results: Consistent with our prior observations, white individuals demonstrated a strong, significant correlation between responses to these drugs (r = 0.

Renin release in response to Renin system blockade: activation of the Renin system in type 1 diabetes mellitus.

Activation of the renin-angiotensin system (RAS) in diabetes is thought to contribute to nephropathy. This is suggested by findings of an enhanced renovascular (RPF) response to RAS blockade with angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs). An alternative approach to assess RAS activation is the evaluation of renin release following RAS blockade.

Body mass index and angiotensin-dependent control of the renal circulation in healthy humans.

Obesity is increasingly recognized as a risk factor for renal disease, but the mechanism is unclear. Renal plasma flow response to captopril, as an index of renin-angiotensin system activity, was measured by para-aminohippurate clearance technique in 100 healthy, normotensive subjects in balance on a high-salt diet. Of the 100 subjects, body mass index exceeded 25 in 56 and exceeded 30 in 22.

Oral contraceptives, angiotensin-dependent renal vasoconstriction, and risk of diabetic nephropathy.

Objective: Diabetes, the leading cause of end-stage renal disease in the U.S., is believed to involve activation of the renin angiotensin system (RAS) as a risk factor for nephropathy.

ACE and non-ACE pathways in the renal vascular response to RAS interruption in type 1 diabetes mellitus.

Background: The enormous contribution of renin-angiotensin system (RAS) interruption with ACE (angiotensin-converting enzyme) inhibitors and angiotensin II receptor blockers (ARB) in the treatment of diabetic nephropathy has led to interest in the factors involved in angiotensin II (Ang II) generation. In normal subjects, RAS interruption using an ARB produced a 50% greater renal plasma flow (RPF) rise than with an ACE inhibitor, suggesting a substantial contribution of non-ACE pathways. Moreover, immunohistochemistry studies in kidneys of overtly proteinuric diabetic subjects showed up-regulation of chymase, an alternative Ang II-generating enzyme.

Plasma aldosterone concentration in the patient with diabetes mellitus.

Background: Vascular injury at the microvascular and macrovascular levels plays a crucial role in the patient with diabetes mellitus. Evidence for renin-system activation in many patients with type 1 diabetes mellitus has raised the possibility that aldosterone-widely recognized as a contributor to vascular injury-could play a role.

Methods: We examined the state of the renin-angiotensin-aldosterone system (RAAS) in 58 subjects with type 1 diabetes mellitus and 64 age-matched normal control subjects.

Renal perfusion in blacks: alterations caused by insuppressibility of intrarenal renin with salt.

We have reported that an increased intrarenal renin-angiotensin system activity may be responsible for the reduction in renal plasma flow (RPF) in apparently healthy blacks in comparison to healthy whites during high salt balance. To ascertain whether these differences only exist in the high salt state, we performed the following study, concentrating on the manipulation of the renin system during low salt intake. We measured in 19 healthy blacks and 22 healthy whites para-aminohippurate and inulin clearances as an indication of RPF and glomerular filtration rate, respectively, on both high (200 mmol/d) and low (10 mmol/d) salt balance in random order.