Renal Artery Smooth Muscle Is Refractory to Contraction by Angiotensin II

Eg, Whitney; Cb, Menice; J, Yeh; Bagwell, Charles A.; Jerius, Hilde; Cm, Brophy

doi:10.1006/jsre.1996.0121

Cited by 4 publications

(3 citation statements)

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“…Two possible mechanisms of NOMI in this patient were: (1) direct hypoperfusion of the intestine and kidneys due to septic shock and (2) spasms of the superior mesenteric artery and both renal arteries caused by endothelin secretion and renin-angiotensin axis activation due to septic shock [ 23 – 30 ]. Vasopressin secretion leads to spasms in the mesenteric arteries, especially in the superior mesenteric artery [ 8 , 9 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the renin–angiotensin axis, especially angiotensin II, can cause selective splenic vaso-spasm, reflecting the high sensitivity of the mesenteric vasculature [ 28 ]. Increased angiotensin II levels are associated with mesenteric ischemia in coronary artery bypass grafting [ 29 ], and angiotensin II can induce contraction in the renal artery smooth muscles [ 30 ]. Overall, these pathophysiological mechanisms can simultaneously cause NOMI and renal vasoconstriction [ 23 – 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Increased angiotensin II levels are associated with mesenteric ischemia in coronary artery bypass grafting [ 29 ], and angiotensin II can induce contraction in the renal artery smooth muscles [ 30 ]. Overall, these pathophysiological mechanisms can simultaneously cause NOMI and renal vasoconstriction [ 23 – 30 ].…”

Section: Discussionmentioning

confidence: 99%

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An Autopsy Case of Nonocclusive Mesenteric Ischemia with Bilateral Renal Artery Vasoconstriction

et al. 2021

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Patient: Male, 84-year-old Final Diagnosis: Bilateral renal artery vasoconstriction • nonocclusive mesenteric ischemia Symptoms: Disturbance of consciousness Medication: — Clinical Procedure: — Specialty: Critical Care Medicine • Nephrology Objective: Unknown etiology Background: Nonocclusive mesenteric ischemia (NOMI) is a life-threatening disease. We present the first case to indicate an association between NOMI and renal infarction caused by renal artery vasoconstriction. Case Report: An 84-year-old Japanese man with no relevant past medical history was evaluated in the Emergency Department for disturbance of consciousness. The patient had a consciousness level of E 1 V 1 M 4 on the Glasgow Coma Scale, temperature of 29.4°C, blood pressure of 90/40 mmHg, regular pulse rate of 48 beats/min, oxygen saturation of 72% while breathing ambient air, abdominal distention, and abdominal tenderness with peritoneal signs. His hemoglobin levels were 3.6 g/dL, blood urea nitrogen per creatinine 54/1.12 mg/dL, plasma glucose 10 mg/dL, and lactate 12.5 mmol/L. Enhanced computed tomography revealed a dilated and distended large transverse colon, spotted poorly enhanced areas in the bilateral kidneys, and poor contrast enhancement of the bilateral renal arteries. The patient died 48 h after admission due to multiple organ failure. An autopsy revealed dappled hemostasis and ischemia in the transverse colon and bilateral kidneys, with no thrombotic infarction in the superior mesenteric artery and/or bilateral renal arteries. We diagnosed NOMI with acute renal tubular necrosis caused by vasoconstriction of the bilateral renal arteries. Conclusions: NOMI can occur simultaneously with renal vasoconstriction, suggesting that NOMI and renal artery vasoconstriction may share mechanisms. This case demonstrates that when enhanced computed tomography shows nonenhancing parenchymal regions in both kidneys, clinicians should check for renal artery vasoconstriction and the life-threatening disease of NOMI.

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