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Renin is an enzyme belonging to the aspartyl-protease family; Renin synthesis was initially detected in the juxtaglomer apparatus of the kidney, but it was later found that it can also occur in the smooth muscle cells of the brain, heart, and arteries.
Renin circulates in two different forms: Prorenin და Active renin. Prorenin is a precursor of renin without enzymatic action; It is converted to active renin in the secretory granules of cells of the juxtaglomerular apparatus.
Active renin has substrate specificity and converts angiotensinogen to biologically inactive angiotensin I.
In turn, angiotensin I is broken down by angiotensin-converting action to form the active octapeptide angiotensin II, the most potent vasopressor, which plays an important role in regulating blood pressure. Angiotensin II also stimulates the production of aldosterone by the adrenal glands;
The renin-aldosterone system controls sodium and potassium balance, blood volume, and blood pressure. Sodium reabsorption in the kidneys affects plasma volume. Hypovolemia, hypotension, and hyponatremia stimulate renin secretion, leading to increased aldosterone levels. Aldosterone causes water retention, increased blood pressure, and loss of potassium.
Renin determination is useful in the differential diagnostics of hypertensive patients. Elevated plasma renin levels are observed in patients with hypertension caused by renal artery stenosis (renal vascular hypertension).
Renin testing may also be helpful in diagnosing patients with primary hyperaldosteronism who typically have low renin levels.
In addition, testing is recommended for patients with primary hyperaldosteronism, first-degree relatives with hypertension. For screening purposes, the guideline recommends estimating the aldosterone / renin ratio in these patients.
Plasma renin is also used to monitor cortisone replacement therapy in patients with adrenal insufficiency.
In most patients with essential hypertension, renin has normal or low levels. However, there is a group of patients in whom renin levels are elevated, which poses an increased risk of developing myocardial infarction or stroke.
In order to detect primary hyperaldosteronism, it is recommended:
Treatment with the drugs that affect the test should be stopped at least 4 weeks before the test: potassium-sparing drugs (spironolactone, amiloride, triamterene, elferonone), potassium-sparing diuretics, and licorice root products (licorice).
A primary hyperaldosteronism test is considered positive if the aldosterone / renin ratio is> 20. Then confirmatory tests (sodium load test, saline infusion test, fludrocortisone suppression test, or captopril test) are used.
Elevated plasma renin and serum aldosterone levels have been reported in renal artery stenosis.
Renin data are important for the appropriateness of performing visual studies of renal blood vessels.
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30 laboratory centers in 11 cities of Georgia: Tbilisi, Kutaisi, Batumi, Kobuleti, Zugdidi, Zestaponi, Rustavi, Marneuli, Akhaltsikhe, Telavi, Gori.
More than 3000 routine and complex / specific diagnostic tests in all major areas of clinical pathology.
"Synevo" - Providing a wide range of diagnostic services in Georgia, offering more than 1,000 routine and specific diagnostic tests in all major areas of clinical pathology. By the end of 2023, the Synevo Georgia network will include 3 clinical laboratories and 47 blood sampling units, which will perform more than 300,000 tests.
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