TY - CHAP M1 - Book, Section TI - ACE Inhibitors and Angiotensin Receptor Blockers A1 - Freeman, Brian S. A2 - Freeman, Brian S. A2 - Berger, Jeffrey S. PY - 2014 T2 - Anesthesiology Core Review: Part One Basic Exam AB - Renin, angiotensin, and aldosterone are three peptide hormones which have an important role in the long-term regulation and homeostasis of blood pressure, intravascular volume, and electrolyte composition. The renin–angiotensin–aldosterone (RAA) system essentially involves the kidney, lungs, and adrenal gland. Juxtaglomulerar (JG) cells within the renal afferent arterioles secrete renin in response to systemic (and afferent arteriolar) hypotension, hypovolemia, and sympathetic nervous system activation of beta-1 receptors. Lower pressures in the afferent arteriole decrease glomerular filtration rate (GFR), which increases sodium reabsorption. Macula densa cells within the distal tubules sense the lower NaCl filtrate concentration and lower the filtrate flow rate and respond by stimulating the JG cells to renin release. In the plasma, renin catalyzes the cleavage of the circulating inactive peptide angiotensinogen (synthesized and secreted by the liver) into the new decapeptide angiotensin I. In the lung capillaries, endothelial angiotensin converting enzyme (ACE) further cleaves angiotensin I into the octapeptide angiotensin II. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/11/01 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1102569762 ER -