RT Book, Section
A1 Freeman, Brian S.
A2 Freeman, Brian S.
A2 Berger, Jeffrey S.
SR Print(0)
ID 1102569762
T1 ACE Inhibitors and Angiotensin Receptor Blockers
T2 Anesthesiology Core Review: Part One Basic Exam
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 9780071821377
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1102569762
RD 2024/04/23
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.