The Renin-Aldosterone Response to Stimulation and Suppression During Normal Pregnancy

Bentley‐Lewis, Rhonda; Graves, Steven W.; Seely, Ellen W.

doi:10.1081/prg-45765

Cited by 24 publications

(18 citation statements)

References 39 publications

(20 reference statements)

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“…Interestingly, the difference in the measured levels of natriuretic peptides can be related to the degree of activation of the renin-angiotensin-aldosterone system (RAAS) that plays a vital role during normal pregnancy [35], and appears differently activated in the various types of hypertension in pregnancy. Studies carried out during normal pregnancy have shown a peculiar activation of the RAAS as evidenced by a disproportionate increase in PRA relative to PA levels [36]. In the present study, the higher levels of both ANP and BNP have been observed in patients showing a lower PRA/ aldosterone ratio (see ''Results'').…”

Section: Discussionsupporting

confidence: 52%

Hemodynamic and neurohumoral profile in patients with different types of hypertension in pregnancy

et al. 2010

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Hypertension in pregnancy is a frequent disorder that includes a spectrum of conditions. We aimed at comparatively evaluating the hemodynamic, echocardiographic and biohumoral profile of a sample of pregnant Caucasian women with different form of pregnancy-related hypertension. We enrolled 39 non-hypertensive pregnant women (NP), 26 with Chronic HBP in pregnancy (CH), 24 with gestational hypertension (G-PIH), and 33 with pre-eclampsia. We recorded and compared blood pressure (BP), echocardiographic parameters, resting plasma renin activity (PRA) and plasma aldosterone (PA), Plasma levels of atrial (ANP) and brain natriuretic peptide (BNP). PE patients had a significantly higher BP than either G-PIH or NP patients. PE patients had also significantly lower cardiac output than NP, G-PIH and CH. In comparison to NP patients, the total peripheral vascular resistance was 61% higher in PE women and 38% higher in CH patients. All echographic parameters were significantly more altered in PE patients when compared with NP, in respect to any other form of hypertension. Either ANP (+35%) and BNP (+40%) were significantly higher in PE patients than in controls. The PRA was reduced in PE and CH patients when compared either with NP (-38 and -35%, respectively) or G-PIH (-47 and -43%, respectively). On the basis of our data, we can conclude that PE is the gestation associated hypertension with the largest anatomical, functional and biohumoral involvement, and so it has to be involved in a more intensive monitoring and evaluation.

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Section: Discussionsupporting

confidence: 52%

Hemodynamic and neurohumoral profile in patients with different types of hypertension in pregnancy

et al. 2010

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“…Aldosterone is particularly responsive to slight changes in volume during pregnancy because volume expansion has been shown to suppress its production (67). In contrast, deoxycorticosterone, which is produced through extra-adrenal hydroxylation of progesterone (68), is not suppressible with a dexamethasone infusion (69).…”

Section: Electrolyte Balancementioning

confidence: 99%

Obstetric Nephrology

Odutayo

Hladunewich

2012

Clinical Journal of the American Society of Nephrology

172

106

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SummaryGlomerular hyperfiltration, altered tubular function, and shifts in electrolyte-fluid balance are among the hallmark renal physiologic changes that characterize a healthy pregnancy. These adjustments are not only critical to maternal and fetal well being, but also provide the clinical context for identifying gestational aberrations in renal function and electrolyte composition. Systemic vasodilation characterizes early gestation and produces increments in renal plasma flow and GFR, the latter of which is maintained into the postpartum period. In addition, renal tubular changes allow for the accumulation of nutrients and electrolytes necessary for fetal growth such that wasting of proteins, glucose, and amino acids in urine is limited in pregnancy and total body stores of electrolytes increase throughout gestation. Substantial insight into the mechanisms underlying these complex adjustments can be gleaned from the available animal and human literature, but our understanding in many areas remains incomplete. This article reviews the available literature on renal adaptation to normal pregnancy, including renal function, tubular function, and electrolyte-fluid balance, along with the clinical ramifications of these adjustments, the limitations of the existing literature, and suggestions for future studies.

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“…These changes in Na + trend may be related to the renin-angiotensin-aldosterone system (RAAS) of the mare that directly controls Na + excretion, internal homeostasis and blood pressure. The effects of pregnancy on RAAS function have been investigated in humans (Weir et al, 1975;Bentley-Lewis et al, 2005), dogs (Robb et al, 1970) and mares (Satué and Domingo, 2011). In particular, an increase in aldosterone concentration was found in mares during late pregnancy (Satué and Domingo, 2011).…”

Section: Discussionmentioning

confidence: 99%

The peripartum period influenced the serum macromineral profile in mares

et al. 2016

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Abstract. Changes in metabolic requirements during pregnancy may produce nutritional imbalances predisposing mares to pathological conditions. Therefore, we aimed to examine changes in serum macrominerals during the peripartum period in mares. Fifteen pregnant mares (Group A) were monitored starting at the 263rd day of pregnancy until the 21st day after foaling. Seven non-pregnant and non-lactating mares were used as a control group (Group B). Group A was subjected to blood sampling within 24 ± 12 h after parturition (P) and then 7, 14 and 21 days after foaling (+1, +2, +3 weeks, respectively). Group B was subjected to regular sampling throughout the study to ensure that seasonal changes had no significant effect on studied parameters. Serum samples were analysed for serum electrolytes including sodium (Na + ), potassium (K + ), calcium (Ca ++ ), phosphorus (P + ), chloride (Cl − ) and magnesium (Mg ++ ). Two-way repeated measures of analysis of variance (ANOVA) was applied to evaluate significant effects of peripartum on electrolyte concentrations. Group A showed a decrease in Cl − concentrations (P = 0.011) after foaling and lower P + concentrations (P = 0.015) compared to Group B throughout the study. The linear regression model showed an increase in Na + concentrations (P = 0.002) and a gradual decrease in serum Ca ++ (P = 0.001) during pregnancy. Because the most significant changes in serum electrolytes occurred within 2 weeks before and 2 weeks after foaling, monitoring serum electrolyte concentrations would indicate whether the mare needs further mineral supplementation at this stage. The significant changes in a mare's macromineral profile that we observed over the peripartum provide enhanced knowledge about mineral interrelations and their modifications during specific physiological conditions such as late pregnancy and early postpartum.

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The Renin-Aldosterone Response to Stimulation and Suppression During Normal Pregnancy

Cited by 24 publications

References 39 publications

Hemodynamic and neurohumoral profile in patients with different types of hypertension in pregnancy

Hemodynamic and neurohumoral profile in patients with different types of hypertension in pregnancy

Obstetric Nephrology

The peripartum period influenced the serum macromineral profile in mares

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