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  • Jun 15, 2022
  • 3 min read

Updated: Feb 18, 2024

Renin Angiotensin Aldosterone System (RAAS)



Role of Renin Angiotensin Aldosterone System (RAAS)
  • RAAS is involved in regulation of...

    • Blood pressure

    • Blood volume

Fall in blood pressure or fall in blood volume

↓

RAAS gets activated

↓ Brings pressure and volume back to normal


Broadly, the Events During RAAS are:

Detection of fall in blood pressure or blood volume

↓

Release of renin from juxtaglomerular cells in the kidney

↓

Synthesis of angiotensin II

↓

Effects of angiotensin II

↓

Brings pressure and volume back to normal


Detection of Fall in Blood Pressure or Blood Volume & Release of Renin

  • There are 3 sites that can detect fall in blood pressure or blood volume:

    • Baroreceptors

    • Macula densa cells

    • Jusgraglomerular cells

  • They all eventually cause the release of renin.

Baroreceptor
  • are located in carotid sinus and aortic arch.

  • are sensitive to stretch in vessel wall.

Fall in blood pressure

↓

Decreased stretching of the vessel wall

↓

Detected by baroreceptors

↓ Send the signals via cranial nerves IX and X

↓ Signal reaches medullary control centers

↓

Increased sympathetic outflow to juxtaglomerular cells in the kidney

↓

Causes release of renin


Macula Densa Cells
  • are part of juxtaglomerular apparatus in kidney.

  • located in ascending limb of loop of Henle of renal tubule.

  • are sensitive to sodium (Na) concentration in the lumen of renal tubule.

Fall in blood pressure or blood volume

↓

Fall in GFR

↓

Decreased Na concentration in lumen of renal tubule at macula densa cells

↓

Detected by macula densa cells

↓

Release nitric oxide and prostaglandins

↓

Stimulate juxtaglomerular cells

↓ Release of renin


Juxtaglomerular Cells
  • are part of juxtaglomerular apparatus in kidney.

  • located in afferent arteriole of the glomerulus.

  • are sensitive to stretch in vessel wall.

Fall in blood pressure or blood volume

↓

Reduced stretch on vessel wall

↓

Detected by juxtaglomerular cells

↓

Release renin


Synthesis of Angiotensin II

Liver releases angiotensinogen

↓

Renin converts agntiotensionogen into angiotensin I

↓

Angiotensin Converting Enzyme (ACE) converts agniotensin I into antiotensin II


Effects of Angiotensin II

Vasoconstriction

Mainly the constriction of arterioles

↓

Increased total peripheral resistance

↓ Increased blood pressure


Constriction of veins to some extend

↓

Increased venous return

↓

Increased cardiac output

↓

Increased blood pressure

Na retention
  • Angiotensin increases Na retention by multiple mechanisms as follows:

Angiotensin II stimulates glomerulosa cells in adrenal cortex

↓

Release of aldosterone

↓ Aldosterone increases synthesis of proteins involved in Na reabsorption in principle cells of collecting duct

↓ Increased Na reabsorption.

...


Angiotensin II increases activity of Na-H exchanger in proximal tubule

↓

Increased reabsorption of Na.

...


Angiotensin II causes constriction of efferent arteriole

↓ 1. Decreased hydrostatic pressure in peritubular capillary.

2. Increased filtration fraction → increased colloid osmotic pressure in peritubular capillary.

↓

Increased uptake of reabsorbate from interstitum into peritubular capillary

↓ Increased reabsorption from renal tubule including that of Na and water.

...


  • Na retention (as explained above) → Causes water retention osmotically → Increased blood volume and blood pressure

Increase Body Water

Angiotensin II acts on hypothalamus

↓

1. Causes release of ADH from hypothalamus → Increased water reabsorption from kidney.

2. Induces thirst → increased water intake.

↓

Increase in body water

↓ Increased blood volume and blood pressure


Termination of Angiotensin II Action

  • Angiotensin II continues to be produced until blood pressure or volume is restored.

  • Half-life of angiotensin II is about 2 minutes.

  • It is degraded by angiotensinases.

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