Role of renin-angiotensin-aldosteron system in pathogenesis of arterial hypertension in chronic renal failure

Aim. To characterize status of renin-angiotensin-aldosteron system (RAAS) i n patients with chronic and terminal renal failure (CRF, TRF) and ifs role in pathogenesis of arterial hypertension (AH). Materials and methods. RAAS was studied in 90 patients with TRF on chronic hemodialysis (CHD) and 17 CRF patients with AH on conservative therapy. Pla sma renin activity (PRA) and the level of plasma aldosteron (PA) were measu red with radioimmunoassay. Results. PRA with moderate CHD-controlled hypertension (1.16 ng/ml/h) was n ot higher than in control group (1.33 ng/ml/h), while in severe hypertensio n PRA was increased 4.6-fold (6.09, p < 0.05). In CRP with severe AH PRA wa s higher 3.6 times (4.8 ng/ml/h, p < 005). PA was in CRF and TRF patients 4 -5 times higher than in healthy controls. A positive correlation was found between PRA and mean dynamic AP (r = 0.448, p < 0.01) and PRA with PA (r = 0.31, p < 0.05). Conclusion. A leading role of RAAS is shown in pathogenesis of AH in patien ts with hemodialysis uncontrolled hypertension and, partially, in patients with CRF and severe AH.