Which factor mediates reno-renal control of renin gene expression?

OBJECTIVE: To obtain information about possible pathways mediating the suppression of renin gene expression in the contralateral kidneys of stenosed kidneys. DESIGN: The effects of unilateral renal denervation and of treatment with an angiotensin II antagonist (losartan) on renal renin gene expression were examined in a two-kidney, one-clip model. METHODS: Renal renin messenger RNA levels, plasma renin activity, blood pressure and kidney weights were monitored over 10 days in adult male Sprague-Dawley rats with various unilateral reductions of renal blood flow achieved with silver clips of 0.2, 0.3 and 0.4 mm inner diameter. RESULTS: With all the clip sizes used, renin messenger RNA levels increased transiently in the clipped kidneys, the time course and the magnitude of the increase being dependent on the degree of flow reduction. In the contralateral kidneys clipping caused sustained decreases in renin messenger RNA to levels proportional to the clip size. The suppression of renin gene expression in the contralateral kidneys was not related to compensatory growth of the organs nor to changes in plasma renin activity or arterial pressure. Unilateral denervation of the kidney before clipping had no influence on the characteristic increase and decrease in renin messenger RNA in the stenosed and contralateral kidneys, respectively. Treatment of the rats with losartan led to fourfold increases in renal renin messenger RNA levels and to sixfold increases in plasma renin activity in control rats. A 0.3-mm clip did not further increase renin messenger RNA or plasma renin activity in losartan-treated rats but again led to suppression of renin messenger RNA in the contralateral kidney to 50% of the levels found in the clipped kidneys. CONCLUSIONS: The results suggest that the suppression of renin gene expression in the contralateral kidneys of stenosed kidneys is not due to compensatory renal growth nor mediated by systemic blood pressure, angiotensin II AT1 receptors or renal nerves. We therefore hypothesize that kidneys with reduced perfusion release a humoral factor that acts as a potent inhibitor of renin gene expression.

Twins--results after changing the management in pregnancy and labor.

Retrospective analysis of the results of management in pregnancy and labor of 598 pregnancies during the period 1986-1990. The influence of prophylactic and therapeutic hospitalization related to the gestational age on the complication rate for premature labor, method of delivery, fetal outcome (APGAR-score, umbilical cord-pH, neonatal mortality) will be presented. There is a need for improvement in antenatal care and the management of delivery including liberal indication for prophylactic hospitalization and for delivery by caesarean section.