The enigma of continual plasma volume expansion in pregnancy: critical role of the renin-angiotensin-aldosterone system.
Am J Physiol Renal Physiol
; 311(6): F1125-F1134, 2016 12 01.
Article
em En
| MEDLINE
| ID: mdl-27707703
ABSTRACT
Pregnancy is characterized by avid renal sodium retention and plasma volume expansion in the presence of decreased blood pressure. Decreased maternal blood pressure is a consequence of reduced systemic vascular tone, which results from an increased production of vasodilators [nitric oxide (NO), prostaglandins, and relaxin] and decreased vascular responsiveness to the potent vasoconstrictor (angiotensin II). The kidneys participate in this vasodilatory response, resulting in marked increases in renal plasma flow and glomerular filtration rate (GFR) during pregnancy. In women, sodium retention drives plasma volume expansion (â¼40%) and is necessary for perfusion of the growing uterus and fetus. For there to be avid sodium retention in the presence of the potent natriuretic influences of increased NO and elevated GFR, there must be modifications of the tubules to prevent salt wasting. The purpose of this review is to summarize these adaptations.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Volume Plasmático
/
Sistema Renina-Angiotensina
/
Fluxo Plasmático Renal
Limite:
Animals
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Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Am J Physiol Renal Physiol
Assunto da revista:
FISIOLOGIA
/
NEFROLOGIA
Ano de publicação:
2016
Tipo de documento:
Article