Document Detail

Adrenergic regulation of renin secretion and renal hemodynamics during deliberate hypotension in humans.
MedLine Citation:
PMID:  8238548     Owner:  NLM     Status:  MEDLINE    
To assess the relative contributions of neural and nonneural stimuli of renin secretion, the effects of an alpha 1-agonist, phenylephrine (Phe), or a beta-agonist, epinephrine (Epi), on plasma renin activity (PRA), renal blood flow (RBF), and glomerular filtration rate (GFR) were compared during sympathetic blockade with epidural hypotensive anesthesia [mean arterial blood pressure (MAP) = 60 and 50 mmHg]. Controls (NaCl) received saline alone to maintain MAP at 50 mmHg. Epi increased PRA ( from 0.9 +/- 0.6 to 3.0 +/- 1.5 at 60 mmHg MAP and 4.7 +/- 1.8 at 50 mmHg MAP, with associated decreases in RBF (-33 and -60%, respectively) and GFR (-27 and -53%, respectively). During hypotension with Phe and NaCl, PRA and RBF were unchanged from baseline but GFR decreased. Urinary Na secretion decreased comparably in all three groups. In conclusion, during sympathetic blockade with epidural anesthesia, marked reductions in both renal perfusion pressure and distal nephron Na delivery were insufficient to increase renin secretion. beta-Adrenergic stimulation (e.g., Epi) was required to increase PRA. Epi decreased RBF suggesting an angiotensin II-mediated effect.
V M Zayas; J D Blumenfeld; B Bading; M McDonald; G D James; Y F Lin; N E Sharrock; J E Sealey; J H Laragh
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of physiology     Volume:  265     ISSN:  0002-9513     ISO Abbreviation:  Am. J. Physiol.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-12-20     Completed Date:  1993-12-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370511     Medline TA:  Am J Physiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  F686-92     Citation Subset:  IM    
Department of Anesthesiology, Hospital for Special Surgery, New York, New York.
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MeSH Terms
Anesthesia, Epidural
Blood Pressure / drug effects
Cardiac Output / drug effects
Diastole / drug effects
Epinephrine / pharmacology*
Glomerular Filtration Rate / drug effects
Heart Rate / drug effects
Hemodynamics / drug effects*
Hip Prosthesis
Hypotension / physiopathology*
Kidney / blood supply,  drug effects,  physiology*
Phenylephrine / pharmacology*
Receptors, Adrenergic / drug effects,  physiology
Renal Circulation / drug effects*,  physiology
Renin / blood,  secretion*
Sodium / urine
Systole / drug effects
Grant Support
Reg. No./Substance:
0/Receptors, Adrenergic; 51-43-4/Epinephrine; 59-42-7/Phenylephrine; 7440-23-5/Sodium; EC

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