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renin-angiotensin-aldosterone axis

Page Kidney

In 1939, Irwin Page performed an experiment in a dog model in which one kidney was wrapped in cellophane. The resultant external compression on the kidney resulted in elevated renin-angiotensin-aldosterone levels and severe hypertension. Over time, a loss…

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Dual ACE/ARB therapy: ONTARGET

The ONTARGET trial was on the major trials looking at the potential benefits of dual ACE-inhibitor (ACE-I)/angiotensin receptor blocker (ARB) therapy.  Although it was not intended to specifically examine the effects of dual blockade of the renin-angiotensin system…

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Review: The Juxtaglomerular Apparatus

The juxtaglomerular apparatus (JGA) is located between the afferent arteriole and the returning distal convoluted tubule of the same nephron. It is responsible for regulating both intrarenal (tubuloglomerular feedback) and extrarenal (renin-angiotensin-aldosterone) mechanisms necessary to maintain both renal…

ACE DD Polymorphism

The human angiotensin coverting enzyme (ACE) gene is located on chromosome 17q23 and is comprised of 26 exons and 25 introns. Importantly, there is an insertion/deletion polymorphism in which a 278-bp fragment is either present or absent within…

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Glucocorticoid-Remediable Aldosteronism

Glucocorticoid-Remediable Aldosteronism (GRA) is an inherited autosomal dominant disorder which causes early-onset (often childhood) high blood pressure, often occuring in individuals with Celtic ancestry. It typically presents with standard symptoms of aldosteronism (hypertension, hypokalemia, and metabolic alkalosis) with…

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Aliskiren

Are renin inhibitors the next big weapon in the fight against hypertension? As we all know, ACE-I’s & ARB’s have so many renoprotective effects that there is substantial evidence towards using these medications as first-line agents for blood…

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