European Journal of Clinical Investigation zyxwvuts (1986) 16,85-90 zyxwv Relationship of angiotensin 11, aldosterone, arginine vasopressin, adrenaline and noradrenaline in plasma, blood and extracellular volumes to blood pressure in chronic glomerulonephritis zyxw H. DANIELSEN*, E. B. PEDERSEN* zyxwvut & N. J. CHRISTENSENT, *Department of Medicine C, Aarhus Kommunehospital and University of Aarhus, Aarhus and ?Department of Medicine F, Herlev Amtssygehus, Copenhagen, Denmark Received 24 January 1985 and in revised form 28 August 1985 Abstract. Blood volume, extracellular volume, blood pressure and the plasma levels of angiotensin 11, aldosterone, adrenaline, noradrenaline and arginine vasopressin were determined in sixteen normotensive (group 1) and thirteen hypertensive patients (group 2) with chronic glomerulonephritis and in eleven normo- tensive control subjects (group 3). Blood volume and extracellular volume did not differ between the groups and no significant differences were found in any of the hormones measured when comparing group 1 or group 2 with group 3. In the hypertensives but not in the normotensives or control subjects, a highly signifi- cant positive correlation was found between diastolic blood pressure and blood volume (rho = 0.75, zyxwvu P< 0.01) and between diastolic blood pressure and extracellular volume (rho = 0.74, P c: 0.01). Blood volume and extracellular volume correlated (P < zyxwvu 0.05) in each of the groups. In conclusion, although no expansion of either blood or extracellular volume was found in chronic glomerulonephritis, a positive volume-pressure relationship could be demonstrated in hypertensive patients suggesting a role of volume factors in the pathogenesis in early stage chronic glomerulonephritis. The study does not give support to a major role of either angiotensin 11, arginine vasopres- sin or catecholamines in the maintenance of non- malignant hypertension in early stage chronic glomer- ulonephritis. Key words. Aldosterone, angiotensin 11, arginine vaso- pressin, blood pressure, blood volume, catechola- mines, chronic glomerulonephritis, extracellular volume. Introduction Arterial hypertension is a common complication of renal parenchymatous disease and often appears dur- ing early stages of the disease with normal or only Correspondence: H. Danielsen, Department of Medicine C, Aarhus Kommunehospital, DK-8000 Aarhus C, Denmark. slightly reduced glomerular filtration rate [ 1-31. The pathogenesis of the elevated blood pressure is still only partially understood. The role of sodium retention assessed by exchangeable sodium in blood pressure elevation is controversial as both increased [4] and decreased [5] values have been found in early stages of kidney disease of various etiologies. The plasma renin activity has been found normal zyx [4, 51 or slightly increased [6], and normal [7] or increased [6] plasma levels of catecholamines have been found. Some of the differences might be explained by the inclusion of kidney diseases of various etiologies, and the present study was therefore confined to a patient group with one well defined renal parenchymatous disease, namely chronic glomerulonephritis. The following were determined: (i) blood and extracellular volumes, the activity of the (ii) renin-angiotensin-aldosterone system and (iii) the osmoregulatory system, (iv) and the plasma levels of adrenaline and noradrenaline. The relationship of the above mentioned parameters (i-iv) to (v) blood pressure and (vi) glomerular filtration rate was also studied. Materials and Methods Patients The study was done in twenty-eight patients with chronic glomerulonephritis, mean age 36 years with creatinine clearance above 10 ml min-', and in eleven normotensive control subjects, age 39 years, without evidence of disease in the kidneys, liver, heart or endocrine organs (group 3, Table 1). Sixteen of the patients were normotensive (group 1) with blood pressure below 140/90 mmHg in the outpatient clinic preceding the study and thirteen hypertensive (group 2) with blood pressure above the limit. One patient was initially normotensive but developed hypertension and was reinvestigated 7 months later and included in both group 1 and group 2. The diagnosis of chronic glomerulonephritis was based on percutaneous renal 85