| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Journal of Clinical Endocrinology & Metabolism, Vol 76, 580-586, Copyright © 1993 by Endocrine Society
ARTICLES |
I Biaggioni, F Garcia, T Inagami and V Haile
Autonomic Dysfunction Center, Vanderbilt University, Nashville, Tennessee 37232.
Sympathetic mechanisms play an important role in the acute regulation of renin release in humans. On the other hand, the effect of chronic sympathetic deprivation on the renin-aldosterone system has not been fully evaluated. We, therefore, studied 24 patients with severe autonomic failure due to pure autonomic failure (n = 14) or to multiple system atrophy (n = 10). Supine plasma renin activity (PRA) was low (0.09 +/- 0.01 ng/(L*s)) and remained virtually unchanged in the upright posture (0.10 +/- 0.01 ng/(L*s)) despite profound orthostatic hypotension to levels that should activate renal baroreceptors. Isoproterenol, at doses that produced significant tachycardia and hypotension, also failed to stimulate PRA. Furthermore, renin-producing cells were absent in the kidneys of two autopsy cases. Norepinephrine depletion alone could not explain these findings because no correlation was found between plasma norepinephrine and PRA, and because PRA was normal in patients with intact sympathetic innervation but congenital absence of norepinephrine. In contrast, supine and upright plasma aldosterone were normal in autonomic failure patients (220 +/- 20 and 440 +/- 70 pmol/L). We speculate that direct sympathetic innervation is essential for the maintenance of renin, perhaps by providing trophic stimuli.
This article has been cited by other articles:
 |
|
 |
|
  L. E. Okamoto, A. Gamboa, C. Shibao, B. K. Black, A. Diedrich, S. R. Raj, D. Robertson, and I. Biaggioni Nocturnal Blood Pressure Dipping in the Hypertension of Autonomic Failure Hypertension, February 1, 2009; 53(2): 363 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Shibao, A. Gamboa, R. Abraham, S. R. Raj, A. Diedrich, B. Black, D. Robertson, and I. Biaggioni Clonidine for the Treatment of Supine Hypertension and Pressure Natriuresis in Autonomic Failure Hypertension, March 1, 2006; 47(3): 522 - 526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Grenon, S. Hurwitz, N. Sheynberg, X. Xiao, C. D. Ramsdell, C. L. Mai, C. Kim, R. J. Cohen, and G. H. Williams Role of individual predisposition in orthostatic intolerance before and after simulated microgravity J Appl Physiol, May 1, 2004; 96(5): 1714 - 1722. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Jacob, F. Costa, and I. Biaggioni Spectrum of Autonomic Cardiovascular Neuropathy in Diabetes Diabetes Care, July 1, 2003; 26(7): 2174 - 2180. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Diedrich, J. Jordan, J. R. Shannon, D. Robertson, and I. Biaggioni Modulation of QT Interval During Autonomic Nervous System Blockade in Humans Circulation, October 22, 2002; 106(17): 2238 - 2243. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. D. Hoeldtke, K. D. Bryner, D. R. McNeill, G. R. Hobbs, J. E. Riggs, S. S. Warehime, I. Christie, G. Ganser, and K. Van Dyke Nitrosative Stress, Uric Acid, and Peripheral Nerve Function in Early Type 1 Diabetes Diabetes, September 1, 2002; 51(9): 2817 - 2825. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Shannon, J. Jordan, A. Diedrich, B. Pohar, B. K. Black, D. Robertson, and I. Biaggioni Sympathetically Mediated Hypertension in Autonomic Failure Circulation, June 13, 2000; 101(23): 2710 - 2715. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. D. Hoeldtke, K. D. Bryner, P. Komanduri, I. Christie, G. Ganser, and G. R. Hobbs Decreased Prorenin Processing Develops before Autonomic Dysfunction in Type 1 Diabetes J. Clin. Endocrinol. Metab., February 1, 2000; 85(2): 585 - 589. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. JORDAN, J. R. SHANNON, B. POHAR, S. Y. PARANJAPE, D. ROBERTSON, R.-M. ROBERTSON, and I. BIAGGIONI Contrasting Effects of Vasodilators on Blood Pressure and Sodium Balance in the Hypertension of Autonomic Failure J. Am. Soc. Nephrol., January 1, 1999; 10(1): 35 - 42. [Abstract] [Full Text]
|
|
|
|
|
|
J. R. Shannon, J. Jordan, B. K. Black, F. Costa, and D. Robertson Uncoupling of the Baroreflex by NN-Cholinergic Blockade in Dissecting the Components of Cardiovascular Regulation Hypertension, July 1, 1998; 32(1): 101 - 107. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Jordan, J. R. Shannon, B. K. Black, R. H. Lance, M. D. Squillante, F. Costa, and D. Robertson NN-Nicotinic Blockade as an Acute Human Model of Autonomic Failure Hypertension, May 1, 1998; 31(5): 1178 - 1184. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Shannon, J. Jordan, F. Costa, R. M. Robertson, and I. Biaggioni The Hypertension of Autonomic Failure and Its Treatment Hypertension, November 1, 1997; 30(5): 1062 - 1067. [Abstract] [Full Text]
|
|
|
|
|
|
H. Hohenbleicher, F. Klosterman, U. Schorr, S. Seyfert, P. B. Persson, and A. M. Sharma Identification of a Renin Threshold and Its Relationship to Salt Intake in a Patient With Pure Autonomic Failure Hypertension, November 1, 1997; 30(5): 1068 - 1071. [Abstract] [Full Text]
|
|
|
|
 |
|
 W. H. Hoffman, J. E. Carroll, G. Y. Perry, P. L. Hartlage, S. J. Kaminer, N. C. Flowers, S. J. Oh, and D. R. Kelly Giant Axonal Neuropathy in a Child With Insulin-Dependent Diabetes Mellitus J Child Neurol, May 1, 1995; 10(3): 250 - 253. [PDF]
|
|
|
|
 |
|
 R. D. Hoeldtke and D. Streeten Treatment of Orthostatic Hypotension with Erythropoietin N. Engl. J. Med., August 26, 1993; 329(9): 611 - 615. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
