. A fluorogenic near-infrared imaging agent for quantifying plasma and local tissue renin activity in vivo and ex vivo. Am J Physiol Renal Physiol 303: F593-F603, 2012. First published June 6, 2012; doi:10.1152/ajprenal.00361.2011.-The renin-angiotensin system (RAS) is well studied for its regulation of blood pressure and fluid homeostasis, as well as for increased activity associated with a variety of diseases and conditions, including cardiovascular disease, diabetes, and kidney disease. The enzyme renin cleaves angiotensinogen to form angiotensin I (ANG I), which is further cleaved by angiotensin-converting enzyme to produce ANG II. Although ANG II is the main effector molecule of the RAS, renin is the rate-limiting enzyme, thus playing a pivotal role in regulating RAS activity in hypertension and organ injury processes. Our objective was to develop a near-infrared fluorescent (NIRF) renin-imaging agent for noninvasive in vivo detection of renin activity as a measure of tissue RAS and in vitro plasma renin activity. We synthesized a reninactivatable agent, ReninSense 680 FAST (ReninSense), using a NIRF-quenched substrate derived from angiotensinogen that is cleaved specifically by purified mouse and rat renin enzymes to generate a fluorescent signal. This agent was assessed in vitro, in vivo, and ex vivo to detect and quantify increases in plasma and kidney renin activity in sodium-sensitive inbred C57BL/6 mice maintained on a low dietary sodium and diuretic regimen. Noninvasive in vivo fluorescence molecular tomographic imaging of the ReninSense signal in the kidney detected increased renin activity in the kidneys of hyperreninemic C57BL/6 mice. The agent also effectively detected renin activity in ex vivo kidneys, kidney tissue sections, and plasma samples. This approach could provide a new tool for assessing disorders linked to altered tissue and plasma renin activity and to monitor the efficacy of therapeutic treatments. optical tomography; low-salt diet; hypertension THE RENIN-ANGIOTENSIN SYSTEM (RAS) plays an important role in the regulation of blood volume, electrolyte homeostasis, and systemic vascular resistance, which together affect cardiac output and arterial pressure (11). Renin, a highly specific aspartyl protease, is primarily stored and released from juxtaglomerular (JG) cells within the afferent arterioles of the kidney glomeruli and plays an important regulatory role in RAS function. JG cells can sense a reduction in afferent arteriole pressure in the kidney leading to direct release of renin, and specialized adjacent cells (the macula densa) can also trigger JG renin release upon sensing of decreased plasma sodium chloride in renal tubules or changes in kidney sympathetic nerve signaling. Release of renin into the blood then mediates the first and rate-limiting step of the RAS cascade by cleaving angiotensinogen to generate angiotensin I (ANG I). ANG I is further cleaved by angiotensin-converting enzyme (ACE) to generate bioactive angiotensin II (ANG II), which binds to angiotensin recepto...