- The Renin-Angiotensin System (RAS) regulates blood pressure, fluid balance, and electrolyte homeostasis, with critical roles in kidney function and cardiovascular health.
Components of the RAS:
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Renin:
- Released by the juxtaglomerular cells in response to low blood pressure, low blood volume, or low sodium.
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Angiotensinogen:
- A protein produced by the liver that is converted to angiotensin I by renin.
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Angiotensin I:
- Inactive, but converted into angiotensin II by angiotensin-converting enzyme (ACE).
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Angiotensin II:
- A potent vasoconstrictor that also stimulates aldosterone secretion from the adrenal cortex.
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Role of RAS in Kidney Functions:
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Regulation of Blood Pressure and Volume
- Angiotensin II causes vasoconstriction, raising blood pressure, and stimulates aldosterone secretion to increase sodium and water reabsorption, raising blood volume.
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Sodium and Water Reabsorption
- Aldosterone promotes sodium reabsorption in the distal tubules and collecting ducts, and water follows sodium, increasing blood volume.
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Direct Action on Kidneys
- Angiotensin II enhances sodium reabsorption in the proximal tubule and reduces renal blood flow by constricting arterioles.
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Feedback Regulation
- High levels of angiotensin II inhibit further renin Natriuresis (excretion of sodium) helps balance sodium reabsorption and water retention, maintaining blood pressure.
Pathophysiological Implications:
- Overactivation of RAS can lead to hypertension and chronic kidney disease, creating a cycle that worsens both kidney function and blood pressure regulation.
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