Renin activation in the venous plasma from the involved kidney in the patient with renal hypertension.

Measurements of plasma renin activity (PRA) in renal vein blood from the ischemic kidney are reported to be generally higher than from the contralateral kidney. Importance of factors other than renin content of renal venous plasma has not been investigated. Initial rate measurements of angiotensin generation with added excess of homologous renin (Plasma Renin Substrate Activity [PRSA]-20 min) were made in bilateral renal venous plasma from 31 patients suspected of suffering from unilateral renal hypertension. The mean values from the involved vs. the contralateral kidney were 551 vs. 331 ng respectively of angiotensin II equivalents generated per milliliter of plasma per 20 min of incubation. The measurement of maximal angiotensin generation under the same conditions with incubation prolonged to 3 hr (PRSA-180 min), however, were bilaterally equal in renal venous plasma from selected patients with renal hypertension who showed distinct differences in PRSA-20 min and PRA measurements. Prior extraction of plasma lipids did not significantly change the bilateral renal venous PRSA-20 min determinations. Stimulation of endogenous renin release in normal dogs did not change the PRSA determinations. The data suggest strongly the presence of a "renin activating" mechanism in the renal venous plasma from the involved kidney of patients with renal hypertension.