Aldosterone and the Renin-Angiotensin System

  • Edward G. Biglieri


Measurement of the components of the mineralocorticoid hormone pathway to aldosterone and of the renin-angiotensin system (RAS) has now been coupled with the ability to measure an effective competitive antagonist of angiotensin II, a converting enzyme inhibitor, and smaller but active fragments of angiotensin II. This combination has permitted further in-depth probes of the system. The aldosterone-renin-angiotensin system (A-RAS) not only is a major effector of pathological disorders, but also can be the marker of events or substances that are more proximate causes of a specific disorder. The effectiveness of inquiries into the A-RAS as a regulator of blood pressure, electrolyte metabolism, and regulation of aldosterone secretion is examined herein.


Zona Glomerulosa Aldosterone Secretion Zona Fasciculata Plasma Aldosterone Concentration Metabolic Clearance Rate 
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  1. 1.
    Brunner, H. R., Gavras, H., Laragh, J. H., and Keenan, R., 1973, Angiotensin II blockade in man by Sar1-Ala8-angiotensin II for understanding and treatment of high blood pressure, Lancet 2:1045–1048.PubMedCrossRefGoogle Scholar
  2. 2.
    Streeten, D. H. P., Anderson, G. H., Jr., and Dalakos, T. G., 1976, Angiotensin blockade: Its clinical significance, Am. J. Med. 60:817–824.PubMedCrossRefGoogle Scholar
  3. 3.
    Case, D. B., Wallace, J. M., Keim, H. J., Sealey, J. E., and Laragh, J. H., 1976, Usefulness and limitations of saralasin, a partial competitive agonist of angiotensin II, for evaluating the renin and sodium factors in hypertensive patients, Am. J. Med. 60:825–836.PubMedCrossRefGoogle Scholar
  4. 4.
    Gavras, H., Ribeiro, A. B., Gavras, I., and Brunner, H. R., 1976, Reciprocal relation between renin dependency and sodium dependency in essential hypertension, N. Engl. J. Med. 295:1278–1283.PubMedCrossRefGoogle Scholar
  5. 5.
    Hollenberg, N. K., Williams, G. H., Burger, B., Ishikawa, L., and Adams, D. F., 1976, Blockade and stimulation of renal, adrenal, and vascular angiotensin II receptors with 1-Sar, 8-Ala angiotensin II in normal man, J. Clin. Invest. 57:39–46.PubMedCrossRefGoogle Scholar
  6. 6.
    Case, D. B., Wallace, J. M., Keim, H. J., Weber, M. A., Drayer, J. I. M., White, R. R., Sealey, J. E., and Laragh, J. H., 1976, Estimating renin participation in hypertension: Superiority of converting enzyme inhibitor over saralasin, Am. J. Med. 61:790–796.PubMedCrossRefGoogle Scholar
  7. 7.
    Christlieb, A. R., Kaldany, A., and D’Elia, J. A., 1976, Plasma renin activity and hypertension in diabetes mellitus, Diabetes 25:969–974.PubMedCrossRefGoogle Scholar
  8. 8.
    De Leiva, A., Christlieb, A. R., Melby, J. C., Graham, C. A., Day, R. P., Luetscher, J. A., and Zager, P. G., 1976, Big renin and biosynthetic defect of aldosterone in diabetes mellitus, N. Engl. J. Med. 295:639–643.CrossRefGoogle Scholar
  9. 9.
    Day, R. P., Luetscher, J. A., and Gonzales, C. M., 1975, Occurrence of big renin in human plasma, amniotic fluid and kidney extracts, J. Clin. Endocrinol Metab. 40:1078–1084.PubMedCrossRefGoogle Scholar
  10. 10.
    Ulick, S., 1976, Diagnosis and nomenclature of the disorders of the terminal portion of the aldosterone biosynthetic pathway, J. Clin. Endocrinol. Metab. 43:92–96.PubMedCrossRefGoogle Scholar
  11. 11.
    Verberckmoes, R., Clement, J., Michielsen, P., and van Damme, B., 1975, Bartter’s syndrome with hyperplasia of renomedullary interstitial cells: Successful treatment with indomethacin, Proc. Int. Soc. of Nephrol., Abst. No. 558 (June 1975).Google Scholar
  12. 12.
    Bartter, F. C., Gill, J. R., Jr., Frolich, J. C., Bowden, R. E., Hollifield, J. W., Radfar, N., Keiser, H. R., Oates, J. A., Seyberth, H., and Taylor, A. A., 1976, Prostaglandins are overproduced by the kidneys and mediate hyperrenine-mia in Bartter’s syndrome, Trans. Assoc. Am. Physicians 89:77–91.PubMedGoogle Scholar
  13. 13.
    Fichman, M. P., Telfer, N., Zia, P., Speckart, P., Golub, M., and Rude, R., 1976, Role of prostaglandins in the pathogenesis of Bartter’s syndrome, Am. J. Med. 60:785–797.PubMedCrossRefGoogle Scholar
  14. 14.
    Verberckmoes, R., van Damme, B., Clement, J., Amery, A., and Michielsen, P., 1976, Bartter’s syndrome with hyperplasia of renomedullary cells: Successful treatment with indomethacin, Kidney Int. 9:302–307.PubMedCrossRefGoogle Scholar
  15. 15.
    Gill, J. R., Jr., Frölich, J. C., Bowden, R. E., Taylor, A. A., Keiser, H. R., Seyberth, H. W., Oates, J. A., and Bartter, F. C., 1976, Bartter’s syndrome: A disorder characterized by high urinary prostaglandins and a dependence of hyperreninemia on prostaglandin synthesis, Am. J. Med. 61:43–51.PubMedCrossRefGoogle Scholar
  16. 16.
    Lechi, A., Covi, G., Lechi, C., Mantero, F., and Scuro, L. A., 1976, Urinary kallikrein excretion in Bartter’s syndrome, J. Clin. Endocrinol. Metab. 43:1175–1178.PubMedCrossRefGoogle Scholar
  17. 17.
    Biglieri, E. G., 1976, A perspective on aldosterone abnormalities, Clin. Endocrinol. (Oxford) 5:399–410.CrossRefGoogle Scholar
  18. 18.
    Oddie, C. J., Coghlan, J. P., and Scoggins, B. A., 1972, Plasma desoxycortico-sterone levels in man with simultaneous measurement of aldosterone, corti-costerone, Cortisol, and 11-deoxyCortisol,J. Clin. Endocrinol. Metab. 34:1039–1054.PubMedCrossRefGoogle Scholar
  19. 19.
    Schambelan, M., and Biglieri, E. G., 1972, Deoxycorticosterone production and regulation in man,J. Clin, Endocrinol. Metab. 34:695–703.CrossRefGoogle Scholar
  20. 20.
    Biglieri, E. G., 1977, Plasma deoxycorticosterone concentrations in adrenal enzymatic deficiencies causing hypertension, in: fuvenile Hypertension (M. I. New and L. S. Levine, eds.), pp. 171–176, Raven Press, New York.Google Scholar
  21. 21.
    Williams, G. H., Braley, L. M., and Underwood, R. H., 1976, The regulation of plasma 18-hydroxy 11-deoxycorticosterone in man, J. Clin. Invest. 58:221–229.PubMedCrossRefGoogle Scholar
  22. 22.
    Melby, J. C., Dale, S. L., Grekin, R. J., Gaunt, R., and Wilson, T. E., 1972, 18-Hydroxy-11-deoxycorticosterone (18-OH-DOC) secretion in experimental and human hypertension, Recent Prog. Horm. Res. 28:287–351.PubMedGoogle Scholar
  23. 23.
    Dale, S. L., Komanicky, P., Pratt, J. H., and Melby, J. C., 1976, Radioimmunoassay of 18-hydroxy-11-deoxycorticosterone in plasma, J. Clin. Endocrinol. Metab. 43:803–809.PubMedCrossRefGoogle Scholar
  24. 24.
    Genest, J., Nowaczynski, W., Kuchel, O., and Sasaki, C., 1972, Progesterone levels and 18 hydroxy-deoxycorticosterone secretion rate in benign essential hypertension in humans, in: Hypertension 1972 (J. Genest and E. Koiw, eds.), pp. 293–298, Springer-Verlag, New York.CrossRefGoogle Scholar
  25. 25.
    Nowaczynski, W., Kuchel, O., Genest, J., Messerli, F. H., Honda, M., Tolis, G., Seth, K., Parvin-Pande, R., Kubo, S., Grose, J., Ledoux, F., and Lebel, M., 1975, Dynamic aldosterone and 18-hydroxydeoxycorticosterone studies in labile and stable benign essential hypertension, J. Steroid Biochem. 6:767–778.PubMedCrossRefGoogle Scholar
  26. 26.
    Martin, V. I., Edwards, C. R. W., Biglieri, E. G., Vinson, G. P., and Bartter, F. C., 1975, The development and application of a radioimmunoassay for 18-hydroxy-corticosterone, Steroids 26:591–604.PubMedCrossRefGoogle Scholar
  27. 27.
    Brunner, H. R., Laragh, J. H., Baer, L., Newton, M. A., Goodwin, F. T., Krakoff, L. R., Bard, R. H., and Bühler, F. R., 1972, Essential hypertension: Renin and aldosterone, heart attack and stroke, iV. Engl. J. Med. 286:441–449.CrossRefGoogle Scholar
  28. 28.
    Biglieri, E. G., Herron, M. A., and Brust, N., 1966, 17-Hydroxylation deficiency in man, J. Clin. Invest. 45:1946–1954.PubMedCrossRefGoogle Scholar
  29. 29.
    Liddle, G. W., Bledsoe, T, and Coppage, W. J., Jr., 1963, A familial renal disorder simulating primary aldosteronism but with negligible aldosterone secretion, Trans. Assoc. Am. Physicians 76:199–213.Google Scholar
  30. 30.
    Sann, L., Revol, A., Zachmann, M., Legrand, J. C., and Bethenod, M., 1976, Unusual low plasma renin hypertension in a child,J.Clin. Endocrinol. Metab. 43:265–271.PubMedCrossRefGoogle Scholar
  31. 31.
    New, M. I., Peterson, R. E., Saenger, P., and Levine, L. S., 1976, Evidence for an unidentified ACTH-induced steroid hormone causing hypertension, J. Clin. Endocrinol Metab. 43:1283–1293.PubMedCrossRefGoogle Scholar
  32. 32.
    Scoggins, B. A., Coghian, J. P., and Denton, D. A., 1976, Mechanism of ACT H induced hypertension, Proc. Endocrine Soc, 58th Meeting, No. 211.Google Scholar
  33. 33.
    Sekihara, H., Sennett, J. A., Liddle, G. W., McKenna, T. J., and Yarbro, L. R., 1976, Plasma 16/3-hydroxydehydroepiandrosterone in normal and pathological conditions in man, J.Clin. Endocrinol. Metab. 43:1078–1084.PubMedCrossRefGoogle Scholar
  34. 34.
    Baxter, J. D., Schambelan, M., Matulich, D. T., Spindler, B. J., Taylor, A. A., and Bartter, F. C., 1976, Aldosterone receptors and the evaluation of plasma mineralocorticoid activity in normal and hypertensive states, J.Clin. Invest. 58:579–589.PubMedCrossRefGoogle Scholar
  35. 35.
    Pratt, J. H., Dale, S. L., and Melby, J. C., 1976, The effect of administered ACTH on aldosterone metabolism and secretion, J. Clin. Endocrinol. Metab. 42:355–360.PubMedCrossRefGoogle Scholar
  36. 36.
    Messerli, F. H., Nowaczynski, W., Honda, M., Genest, J., and Kuchel, O., 1976, Effects of ACTH on steroid metabolism, J. Clin. Endocrinol. Metab. 42:1074–1080.PubMedCrossRefGoogle Scholar
  37. 37.
    Zipser, R. D., Speckart, P. F., Zia, P. K., Edmiston, W. A., Lau, F. Y. K., and Horton, R., 1976, The effect of ACTH and Cortisol on aldosterone and Cortisol clearance and distribution in plasma and whole blood, J. Clin. Endocrinol. Metab. 43:1101–1109.PubMedCrossRefGoogle Scholar
  38. 38.
    Zager, P. G., Burtis, W. J., Luetscher, J. A., Dowdy, A. J., and Sood, S., 1976, Increased plasma protein binding and lower metabolic clearance rate of aldosterone in plasma of low Cortisol concentration,J. Clin. Endocrinol. Metab. 42:207–214.PubMedCrossRefGoogle Scholar
  39. 39.
    Kono, T., Oseko, F., Shimpo, S., Nanno, M., and Endo, J., 1975, Biological activity of des-Asp1-angiotensin II (angiotensin III) in man, J. Clin. Endocrinol. Metab. 41:1174–1177.PubMedCrossRefGoogle Scholar
  40. 40.
    Bravo, E. L., Khosla, M. C., and Bumpus, F. M., 1975, Action of (1-des (aspartic acid) 8-isoleucine) angiotensin II upon the pressor and steroidogenic activity of angiotensin 11,J. Clin. Endocrinol. Metab. 40:530–533.PubMedCrossRefGoogle Scholar
  41. 41.
    Kono, T., Oseko, F., Ikeda, F., Nanno, M., and Endo, J., 1976, Biological activity of des-Asp1,Ileu8-angiotensin II (Ileu8-angiotensin III) in man, J. Clin. Endocrinol Metab. 43:940–943.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1978

Authors and Affiliations

  • Edward G. Biglieri
    • 1
    • 2
  1. 1.Endocrinology Division of the Medical Service and the Clinical Study CenterSan Francisco General HospitalSan FranciscoUSA
  2. 2.Department of MedicineUniversity of CaliforniaSan FranciscoUSA

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