Context: Peroxisome proliferator-activated receptor gamma (PPARgamma) agonists often cause volume retention and edema. A relationship between PPARgamma and renin may play a role in this process.
Objective: The aim was to examine the relationship between the PPARgamma gene and plasma renin activity (PRA) levels in human hypertension.
Design, Participants, And Measures: A candidate gene association study was conducted with two distinct groups of human participants: Caucasian hypertensives (n = 395) and African-American hypertensives (n = 55). Single nucleotide polymorphisms of the PPAR(Upsilon) gene were analyzed. Phenotype studies were conducted after participants consumed a low-salt diet (10 mmol/d) for 7 d and included PRA and aldosterone measurements before and after a 60-min angiotensin II infusion (3 ng/kg x min).
Results: Participants homozygous for the minor allele of rs2959272 (CC) had significantly higher PRA levels at baseline (P = 0.016) than major allele carriers (AA, AC) in Caucasian-hypertensive participants. The association of the C allele carrier status with increased PRA levels was replicated in the group of African-American hypertensive participants (P = 0.027). The Fisher's combined P value for both observations was significant (P = 0.002).
Conclusions: These results demonstrate the first known association between a PPARgamma single nucleotide polymorphism and alterations in PRA levels in humans with hypertension. This link between PPARgamma and renin raises the possibility of a genetically based mechanism for the increased volume retention and edema in some users of PPARgamma agonists.
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http://dx.doi.org/10.1210/jc.2010-0270 | DOI Listing |
Cureus
December 2024
Gastroenterolgy, Sindh Institute of Urology and Transplantation, Karachi, PAK.
Background Heart failure (HF) is commonly managed by addressing water and sodium (Na) balance, with arterial circulation playing a major role in influencing renal Na and water excretion. Recently, chloride (Cl) has been recognized as an important factor in HF, associated with volume regulation and its modulation of renin-angiotensin-aldosterone system (RAAS) activity through macula densa signaling, which impacts Na retention and neurohormonal activation. Acetazolamide, a carbonic anhydrase inhibitor, can enhance decongestion in HF by increasing urinary Na and Cl excretion when added to loop diuretics, a mechanism supported by prior studies demonstrating improved urine output and decongestion.
View Article and Find Full Text PDFAnn Intensive Care
January 2025
Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria.
Background: Acute respiratory distress syndrome (ARDS) associated with coronavirus infectious disease (COVID)-19 has been a challenge in intensive care medicine for the past three years. Dysregulation of the renin-angiotensin system (RAS) is linked to COVID-19, but also to non-COVID-19 ARDS. It is still unclear whether changes in the RAS are associated with prognosis of severe COVID-19.
View Article and Find Full Text PDFClin J Am Soc Nephrol
January 2025
Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Key Points: The effect of sodium-glucose cotransporter 2 inhibitors in preventing kidney outcomes in populations at lower risk of kidney disease remains uncertain. Pooled data from randomized controlled trials show that sodium-glucose cotransporter 2 inhibitors prevent kidney outcomes across the spectrum of kidney disease risk.
Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown to reduce clinically meaningful kidney outcomes in individuals with CKD at high risk of adverse outcomes.
JCEM Case Rep
January 2025
Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Tokyo 162-8666, Japan.
A 37-year-old man presented with symptoms of polyuria and weight loss over the past year. Initial laboratory examination showed elevated blood glucose level (468 mg/dL [25.9 mmol/L]; normal reference range [RR], 75-109 mg/dL [4.
View Article and Find Full Text PDFBMJ Open
January 2025
School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
Objective: Physical activity (PA) has been generally recognised as beneficial for health. The effect of a change in PA on kidney biomarkers in healthy individuals without kidney disease remains unclear. This manuscript synthesised the evidence of the association of changes in PA with kidney biomarkers in the general population free from kidney disease.
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