Skip to main content
NCBI home page
British Medical Journal logoLink to British Medical Journal
. 1972 Dec 30;4(5843):749–753. doi: 10.1136/bmj.4.5843.749

Plasma Renin Activity and Blood Pressure in 89 Patients Receiving Maintenance Haemodialysis Therapy

P W Craswell, V M Hird, P A Judd, R A Baillod, Z Varghese, J F Moorhead
PMCID: PMC1787062  PMID: 4345832

Abstract

Blood pressure, plasma renin activity, plasma sodium concentration, plasma potassium concentration, dietary sodium intake, and duration of dialysis have been measured under standard conditions in 89 patients on maintenance haemodialysis. No significant relation was found between plasma renin activity and blood pressure. Statistically significant correlations were found between plasma renin activity and plasma sodium concentration and between plasma renin activity and dietary sodium intake.

Only one patient was found to have uncontrollable hypertension associated with a markedly raised plasma renin activity. Reasons are given for not performing bilateral nephrectomy in this patient. We believe the low incidence of uncontrollable hypertension and hyperreninaemia in our patients to be due to their slow introduction to haemodialysis, thus preventing violent swings in body weight, blood pressure, and renin secretion.

Although plasma renin activity did fall with duration of dialysis, all 15 patients who have been on maintenance dialysis for longer than five years have normal levels.

Full text

PDF
749

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BROWN J. J., DAVIES D. L., LEVER A. F., ROBERTSON J. I. INFLUENCE OF SODIUM DEPRIVATION AND LOADING ON THE PLASMA-RENIN IN MAN. J Physiol. 1964 Oct;173:408–419. doi: 10.1113/jphysiol.1964.sp007464. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BROWN J. J., DAVIES D. L., LEVER A. F., ROBERTSON J. I. PLASMA RENIN CONCENTRATION IN HUMAN HYPERTENSION. 1. RELATIONSHIP BETWEEN RENIN, SODIUM, AND POTASSIUM. Br Med J. 1965 Jul 17;2(5454):144–148. doi: 10.1136/bmj.2.5454.144. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Baillod R. Training principles and management of home dialysis. J Ir Med Assoc. 1971 Sep 9;64(419):448–453. [PubMed] [Google Scholar]
  4. Bayard F., Cooke C. R., Tiller D. J., Beitins I. Z., Kowarski A., Walker W. G., Migeon C. J. The regulation of aldosterone secretion in anephric man. J Clin Invest. 1971 Aug;50(8):1585–1595. doi: 10.1172/JCI106646. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bianchi G., Ponticelli C., Bardi U., Redaelli B., Campolo L., De Ponti C., Graziani G. Role of the kidney in 'salt and water dependent hypertension' of end-stage disease. Clin Sci. 1972 Jan;42(1):47–55. doi: 10.1042/cs0420047. [DOI] [PubMed] [Google Scholar]
  6. Blumberg A., Nelp W. B., Hegstrom R. M., Scribner B. H. Extracellular volume in patients with chronic renal disease treated for hypertension by sodium restriction. Lancet. 1967 Jul 8;2(7506):69–73. doi: 10.1016/s0140-6736(67)92061-2. [DOI] [PubMed] [Google Scholar]
  7. Brown J. J., Curtis J. R., Lever A. F., Robertson J. I., De Wardener H. E., Wing A. J. Plasma renin concentration and the control of blood pressure in patients on maintenance haemodialysis. Nephron. 1969;6(3):329–349. doi: 10.1159/000179737. [DOI] [PubMed] [Google Scholar]
  8. Brown J. J., Düsterdieck G., Fraser R., Lever A. F., Robertson J. I., Tree M., Weir R. J. Hypertension and chronic renal failure. Br Med Bull. 1971 May;27(2):128–135. doi: 10.1093/oxfordjournals.bmb.a070835. [DOI] [PubMed] [Google Scholar]
  9. Curtis J. R., Eastwood J. B., Smith E. K., Storey J. M., Verroust P. J., de Wardener H. E., Wing A. J., Wolfson E. M. Maintenance haemodialysis. Q J Med. 1969 Jan;38(149):49–89. [PubMed] [Google Scholar]
  10. Davis J. O. What signals the kidney to release renin? Circ Res. 1971 Mar;28(3):301–306. doi: 10.1161/01.res.28.3.301. [DOI] [PubMed] [Google Scholar]
  11. Dustan H. P., Tarazi R. C., Frohlich E. D. Functional correlates of plasma renin activity in hypertensive patients. Circulation. 1970 Mar;41(3):555–567. doi: 10.1161/01.cir.41.3.555. [DOI] [PubMed] [Google Scholar]
  12. Fraser D. R., Kodicek E. Unique biosynthesis by kidney of a biological active vitamin D metabolite. Nature. 1970 Nov 21;228(5273):764–766. doi: 10.1038/228764a0. [DOI] [PubMed] [Google Scholar]
  13. Gordon R. D., Pawsey C. G. The relative effects of serum sodium concentration and the state of body fluid balance on renin secretion. J Clin Endocrinol Metab. 1971 Jan;32(1):117–119. doi: 10.1210/jcem-32-1-117. [DOI] [PubMed] [Google Scholar]
  14. Haber E., Koerner T., Page L. B., Kliman B., Purnode A. Application of a radioimmunoassay for angiotensin I to the physiologic measurements of plasma renin activity in normal human subjects. J Clin Endocrinol Metab. 1969 Oct;29(10):1349–1355. doi: 10.1210/jcem-29-10-1349. [DOI] [PubMed] [Google Scholar]
  15. Hampers C. L., Skillman J. J., Lyons J. H., Olsen J. E., Merrill J. P. A hemodynamic evaluation of bilateral nephrectomy and hemodialysis in hypertensive man. Circulation. 1967 Feb;35(2):272–288. doi: 10.1161/01.cir.35.2.272. [DOI] [PubMed] [Google Scholar]
  16. KOLFF W. J., NAKAMOTO S., SCUDDER J. P. Experiences with long-term intermittent dialyses. Trans Am Soc Artif Intern Organs. 1962;8:292–299. doi: 10.1097/00002480-196204000-00059. [DOI] [PubMed] [Google Scholar]
  17. Kono S. [Estimation of the plasma renin activity in terminal renal failure and its use for the factor determining indication of the bilateral nephrectomy]. Nihon Hinyokika Gakkai Zasshi. 1970 Oct;61(10):939–954. doi: 10.5980/jpnjurol1928.61.10_939. [DOI] [PubMed] [Google Scholar]
  18. Ledingham J. G., Bull M. B., Laragh J. H. The meaning of aldosteronism in hypertensive disease. Circ Res. 1967 Jul;21(1 Suppl):177+–177+. [PubMed] [Google Scholar]
  19. Ledingham J. M. Blood-pressure regulation in renal failure. J R Coll Physicians Lond. 1971 Jan;5(2):103–134. [PMC free article] [PubMed] [Google Scholar]
  20. MAHER J. F., FREEMAN R. B., SCHREINER G. E. HEMODIALYSIS FOR CHRONIC RENAL FAILURE. II. BIOCHEMICAL AND CLINICAL ASPECTS. Ann Intern Med. 1965 Mar;62:535–550. doi: 10.7326/0003-4819-62-3-535. [DOI] [PubMed] [Google Scholar]
  21. Newsome H. H., Bartter F. C. Plasma renin activity in relation to serum sodium concentration and body fluid balance. J Clin Endocrinol Metab. 1968 Dec;28(12):1704–1711. doi: 10.1210/jcem-28-12-1704. [DOI] [PubMed] [Google Scholar]
  22. Nielsen I., Clausen E., Jensen G. Plasma renin activity in chronic nephropathy. Acta Med Scand. 1970 Nov;188(5):351–354. doi: 10.1111/j.0954-6820.1970.tb08050.x. [DOI] [PubMed] [Google Scholar]
  23. Onesti G., Swartz C., Ramirez O., Brest A. N. Bilateral nephrectomy for control of hypertension in uremia. Trans Am Soc Artif Intern Organs. 1968;14:361–366. [PubMed] [Google Scholar]
  24. Pendras J. P., Erickson R. V. Hemodialysis: a successful therapy for chronic uremia. Ann Intern Med. 1966 Feb;64(2):293–311. doi: 10.7326/0003-4819-64-2-293. [DOI] [PubMed] [Google Scholar]
  25. Schupak E., Sullivan J. F., Lee D. Y. Chronic hemodialysis in "unselected" patients. Ann Intern Med. 1967 Oct;67(4):708–717. doi: 10.7326/0003-4819-67-4-708. [DOI] [PubMed] [Google Scholar]
  26. Stokes G. S., Goldsmith R. F., Starr L. M., Gentle J. L., Mani M. K., Stewart J. H. Plasma renin activity in human hypertension. Circ Res. 1970 Oct;27(Suppl):207+–207+. [PubMed] [Google Scholar]
  27. Van Ypersele de Strihou, Stragier A. Effect of bilateral nephrectomy on transfusion requirements of patients undergoing chronic dialysis. Lancet. 1969 Oct 4;2(7623):705–707. doi: 10.1016/s0140-6736(69)90424-3. [DOI] [PubMed] [Google Scholar]
  28. Verniory A., Potvliege P., Van Geertruyden J. J., Vereerstraeten P., Kinnaert P., Staroukine M., Toussaint C. Renin and control of arterial blood pressure during terminal renal failure treated by haemodialysis and by transplantation. Clin Sci. 1972 Jun;42(6):685–700. doi: 10.1042/cs0420685. [DOI] [PubMed] [Google Scholar]
  29. Vertes V., Cangiano J. L., Berman L. B., Gould A. Hypertension in end-stage renal disease. N Engl J Med. 1969 May 1;280(18):978–981. doi: 10.1056/NEJM196905012801802. [DOI] [PubMed] [Google Scholar]
  30. Warren D. J., Ferris T. F. Renin secretion in renal hypertension. Lancet. 1970 Jan 24;1(7639):159–162. doi: 10.1016/s0140-6736(70)90404-6. [DOI] [PubMed] [Google Scholar]
  31. Weidmann P., Maxwell M. H., Lupu A. N., Lewin A. J., Massry S. G. Plasma renin activity and blood pressure in terminal renal failure. N Engl J Med. 1971 Sep 30;285(14):757–762. doi: 10.1056/NEJM197109302851401. [DOI] [PubMed] [Google Scholar]
  32. Wilkinson R., Scott D. F., Uldall P. R., Kerr D. N., Swinney J. Plasma renin and exchangeable sodium in the hypertension of chronic renal failure. The effect of bilateral nephrectomy. Q J Med. 1970 Jul;39(155):377–394. [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES