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European Heart Journal 1990 11(Supplement D):44-52; doi:10.1093/eurheartj/11.suppl_D.44
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Why do the kidneys release renin in patients with congestive heart failure? A nephrocentric view of converting-enzyme inhibition*

M. Packer

The Mount Sinai Medical Centre New York, U.S.A.

Address for correspondence: Milton Packer, M.D., Division of Cardiology, The Mount Sinai Medical Center, 1 Gustave Levy Place, New York, New York 10029, U.S.A.

I have never yet examined the body of a patient dying of dropsy attended by coagulable urine, in whom some obvious derangement was not discovered in the kidneys....

In all cases, ... it has appeared to me that the kidneys has itself acted a more important part, and has been more deranged both functionally and organically than has generally been imagined.

Superficially, it might be said that the function of the kidneys is to make urine, but in a more considered view, one can say that the kidneys make the stuff of philosophy itself.

Key Words: Renin • congestive heart failure • ACE inhibitors

* This article was originally published in the American Journal of Cardiology 1987: 60: 179-84. This study was supported by Grants R01-HL-25055 and K04-HL-01229 from the National Heart, Lung and Blood Institute, Bethesda, Maryland.


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