Plasma renin-substrate levels remain relatively constant across various hypertensive and renal diseases despite significant fluctuations in plasma renin activity, except in nephrotic syndrome where substrate may be lost in urine.
Renin-substrate constancy across most diseases suggests limited added value for its routine measurement; leaves open its potential role in nephrotic syndrome pending prospective studies.
The content of renin and renin-substrate (angiotensinogen) in the peripheral plasma was estimated simultaneously on 36 patients under various clinical conditions including essential hypertension, malignant hypertension, renovascular hypertension, chronic glomerulonephritis, and nephrotic syndrome. No quantitative relation between the renin activity and renin-substrate was detected in the above-mentioned diseases. It was concluded that renin-substrate is maintained fairly constant within normal range irrespective of renin activity which varied greatly according to the diseases. As an exception, however, nephrotic patients showed elevated levels in renin activity and rather subnormal values in its substrate.
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Aida et al. (1965) studied this question.
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