Tsai T J, Wu C Y, Chen Y M, Hsieh B S, Chen W Y, Yen T S
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, R.O.C.
J Formos Med Assoc. 1991 Sep;90(9):871-3.
To investigate the physiologic role of plasma inactive renin and its relationship to plasma kallikrein, we measured the changes in plasma active renin, inactive renin and prekallikrein levels in 14 uremic patients before and after hemodialysis. Blood was collected before, during and after hemodialysis, and prior to the next dialysis session. Plasma active renin was measured by radioimmunoassay of generated angiotensin I after addition of an exogenous substrate. Plasma inactive renin was activated by trypsin. Plasma prekallikrein was measured by the kallikrein-like activity on synthetic substrate S-2302 after activation of prekallikrein. The results showed that there was no change in blood pressure before, during or after dialysis, whereas the change in body weight after dialysis was significant. There was also no significant difference in the plasma active renin, inactive renin and prekallikrein levels for any of the collection periods. Plasma active renin was significantly correlated with inactive renin. The correlation between the active renin/total renin ratio and the plasma prekallikrein level was also not significant. These results suggest that in uremic patients undergoing chronic hemodialysis, the response of the renin system to acute plasma volume change is blunted. These data only provide evidence that plasma active renin is linked with inactive renin, but provide no evidence to support the idea that plasma inactive renin is a precursor of active renin or that plasma kallikrein is related to activation of inactive renin in vivo.
为研究血浆无活性肾素的生理作用及其与血浆激肽释放酶的关系，我们测定了14例尿毒症患者血液透析前后血浆活性肾素、无活性肾素和前激肽释放酶水平的变化。在血液透析前、透析期间、透析后以及下次透析前采集血液。血浆活性肾素通过添加外源性底物后对生成的血管紧张素I进行放射免疫测定。血浆无活性肾素用胰蛋白酶激活。血浆前激肽释放酶通过前激肽释放酶激活后对合成底物S - 2302的类激肽释放酶活性进行测定。结果显示，透析前、透析期间或透析后血压均无变化，而透析后体重变化显著。在任何采集时间段，血浆活性肾素、无活性肾素和前激肽释放酶水平也无显著差异。血浆活性肾素与无活性肾素显著相关。活性肾素/总肾素比值与血浆前激肽释放酶水平之间的相关性也不显著。这些结果表明，在接受慢性血液透析的尿毒症患者中，肾素系统对急性血容量变化的反应减弱。这些数据仅证明血浆活性肾素与无活性肾素有关，但没有证据支持血浆无活性肾素是活性肾素的前体或血浆激肽释放酶与体内无活性肾素的激活有关这一观点。
