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Cited by 182Renin-Angiotensin System StudiesHormonal Regulation and HypertensionBlood Pressure and Hypertension Studies

Sodium, renin, aldosterone, catecholamines, and blood pressure in diabetes mellitus

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de Châtel, Rudolf, Weidmann, Peter, Flammer, Josef, Ziegler, Walter H., Beretta-Piccoli, Carlo, Vetter, Wilhelm, Reubi, François C.·1977·Kidney International
DOI 10.1038/ki.1977.132
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Abstract

Interrelations among plasma renin activity (PRA), aldosterone and cortisole levels, 0lood volume, exchangeable sodium, urinary catecholamines, and blood pressure were studied in 35 normal subjects and 60 age-matched non-azotemic patients with diabetes mellitus (60% with hypertension, 15% with orthostatic hypotension). Basal PRA, plasma aldosterone, cortisol, blood volume, plasma potassium, and urinary electrolytes were comparable in diabetic and normal subjects. Diabetic patients, however, had a 10% increase in body sodium (P less than 0.01), and 8% of them showed normal postural PRA responses and subnormal aldosterone responses; 22% had subnormal PRA and normal aldosterone responses, and 17% had subnormal responses of PRA and aldosterone. Non-PRA-related aldosterone responses could not be explained by ACTH or electrolytes. Orthostatic decreases in blood pressure correlated (P less than 0.01) with both catecholamine excretion and basal PRA. This suggests that in diabetes mellitus, body sodium is increased. Basal PRA and plasma aldosterone are usually normal, but their postural responses are frequently impaired. Absent aldosterone responses, despite normal PRA responsiveness, may reflect an adrenal abnormality or an ineffective form of renin. Marked postural aldosterone stimulation, unrelated to PRA, ACTH, or electrolytes, points to a potent unknown factor in aldosterone control. Low levels of free peripheral catecholamines and PRA may be complementary factors contributing to postural hypotension.

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Authors
de Châtel, R., Weidmann, P., Flammer, J., Ziegler, W. H., Beretta-Piccoli, C., Vetter, W., & Reubi, F. C.
Affiliations
University of Bern (CH)
Venue
Kidney International
Publisher
Elsevier BV
Published
1977-12
Volume
12
Issue
6
Pages
412-421
ISSN
0085-2538 (ISSN-L)
DOI
10.1038/ki.1977.132
OpenAlex
W1963655685
Cited by
182
References
45
Citations by year
2022: 2 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 1 · 2012: 1
FWCI
5.52
Type
journal article
Language
en
Open access
Licence
Locations
  • Kidney International (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
diabetes mellitus, plasma renin activity, aldosterone, catecholamines, blood pressure, orthostatic hypotension, hypertension, body sodium, ACTH, adrenal function, urinary electrolytes, blood volume, plasma potassium, exchangeable sodium, renin-angiotensin system, cortisol, aldosterone regulation
MeSH terms
Adult, Aged, Aldosterone, Blood Pressure, Blood Volume, Catecholamines, Diabetes Mellitus, Female, Heart Rate, Humans, Hypertension, Renal, Male, Middle Aged, Renin, Sodium, Diabetes Complications

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