Juxtaglomerular apparatus hyperplasia under dual angiotensin blockade. A footprint of adequate RAS inhibition or a concern for renal fibrosis?
Entity
UAM. Departamento de MedicinaPublisher
BioMed CentralDate
2012-04-26Citation
10.1186/1471-2369-13-21
BMC Nephrology 13 (2012): 21
ISSN
1471-2369DOI
10.1186/1471-2369-13-21Funded by
The authors have been supported by FIS PI 10/00072, PS09/00447, ISCIIIRETIC REDinREN RD06/0016, MICINN (SAF2009/11794), Eurosalud (EUS 2008/ 03565) FRIAT (Fundación Renal Iñigo Álvarez de Toledo) and Fundacion Lilly (JE).Editor's Version
http://dx.doi.org/10.1186/1471-2369-13-21Subjects
Angiotensin; Juxtaglomerular apparatus hyperplasia; Nephrotic syndrome; Paricalcitol; Renin; MedicinaRights
© 2012 Fernandez-Fernandez et al.Abstract
Background: Dual renin-angiotensin system blockade with angiotensin-converting enzyme inhibitors and
angiotensin receptor blockers has been advocated to minimize proteinuria. However, recent trials have questioned
the renal safety of this approach. Our understanding on the molecular effects of dual blockade in humans is
incomplete.
Case presentation: We present a patient with corticoid resistant nephrotic syndrome who developed marked
juxtaglomerular apparatus hyperplasia and renin expression in the context of dual angiotensin system blockade.
Conclusions: Although renin may have profibrotic effects mediated by (pro)renin receptor activation, this report
raises questions on the potential consequences of local renin activation on chronic kidney disease in patients with
dual angiotensin blockade.
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Google Scholar:Fernández Fernández, Beatriz
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Ortiz Arduán, Alberto
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Gómez-Guerrero, Carmen
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Barat, Antonio
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Martín-Cleary, Catalina
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Egido de los Ríos, Jesús
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