Since the advent of minimally invasive renal denervation procedures about a decade ago, the nephrology community had been eagerly awaiting conclusion of the SYMPLICITY 3 trial. As many of you might already know, Medtronic, the device’s company issued…
Over the past few years, it has become apparent that hyperaldosteronism is far commoner than was once suspected and screening of unselected patients with hypertension reveals that about 5-10% of patients have primary hyperaldosteronism. In patients with resistant…
Researchers from the UK published a new and exciting article exploring one of the fundamental mechanisms of blood pressure regulation by the renin-angiotensin-system (RAS). This research was, per the authors, 20 years in the making and was fittingly…
I recently saw a young hypertensive patient who had suffered a motor vehicle accident complicated by a transected aorta that was successfully repaired several years back. He has had hypertension since then and was referred to us for…
Since the retraction of the COOPERATE trial by the Lancet late last year (following Regina Kunz’s famous ‘letter of concern’), combination RAAS blockade has suffered something of a fall from grace. This was dealt a second blow by…
The renin-angiotensin system is powerful regulator of blood pressure homeostasis. An article published in the March 24 issue of JASN highlights an emerging area of research into the modulation of AT1 receptors on different tissues. The majority of…
A promising new class of oral hypoglycemic agents for type 2 diabetes, the SGLT inhibitors, are on the horizon. As they work on the kidney, and potentially have renal side effects, it may be helpful to review them….
One of the coolest aspects of the renin-angiotensin-aldosterone system (RAAS) is that it involves multiple organ systems: the liver, lung, adrenal gland, kidney, and vasculature are all prominently involved. It never hurts to review basic physiologic principles, right?…
Fibromuscular dysplasia (FMD) accounts for a significant fraction of renal artery stenosis. The distinction between fibromuscular dysplasia and atherosclerotic renal artery stenosis is important as the former tends to respond much more readily to interventional therapy than the…
I didn’t learn this until recently, but some commonly used oral contraceptives–for example Yasmin-28 (the progestin-derivative drospirenone + ethinyl estradiol)–has some mineralocorticoid blocking effect, similar to that seen for spironolactone. It may therefore be associated with hyperkalemia, particularly…
