New roles for renin in heart failure and cardio-renal interaction

There is a strong reciprocal relation between heart and kidney function. Damage to either, often leads to damage of the other. The hormone renin plays an important role in the communication between heart and kidneys, mainly through blood pressure regulation. It is, however, unclear whether renin exerts harmful effects of its own.

To clarify this, we measured renin levels in 6000 healthy individuals. In these subjects, high renin appeared to be related to an increased risk for cardiovascular disease. The relation with kidney function was less clear.

Furthermore we studied renal function and hormones in heart failure patients. In contrast to healthy individuals, in these patients renal function appeared to be highly dependent on renal blood flow. Furthermore many heart failure patients had a vitamin D deficiency and very high renin levels and vitamin D supplementation reduced renin levels. In patients with both heart failure and renal dysfunction direct blockade of renin activity with a renin blocker, however, did not improve renal blood flow and reduced the renal filtration rate.

In conclusion, renin plays an important role in the development of cardiac and renal disease, but it appears to have both harmful and beneficial effect. Hopefully, in the near future we will be able to modulate these hormones to block the harmful and stimulate the beneficial effects.

Dissertation: http://irs.ub.rug.nl/ppn/386114099

Dissertation: http://irs.ub.rug.nl/ppn/386114099