Figure 237

Plasma renin activity (PRA) and atrial natriuretic peptide (ANP) concentration in the nephrotic syndrome. Shown are PRA and ANP concentration (+standard error) in normal persons ingesting diets high (300 mEq/d) and low (20 mEq/d) in sodium (Na) and in patients with acute glomerulonephritis (AGN), predominantly poststreptococcal, or nephrotic syndrome (NS). Note that PRA is suppressed in patients with AGN to levels below those in normal persons on diets high in Na. PRA suppression suggests that primary renal NaCl retention plays an important role in the pathogenesis of volume expansion in AGN. Although plasma renin activity in patients with nephrotic syndrome is not suppressed to the same degree, the absence of PRA elevation in these patients suggests that primary renal Na retention plays a significant role in the pathogen-esis of Na retention in NS as well. (Data from Rodrigeuez-Iturbe and coworkers [71].)

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