Renal and Hormonal Responses to Direct Renin Inhibition With Aliskiren in Healthy Humans

Abstract

Background— Pharmacological interruption of the renin-angiotensin system focuses on optimization of blockade. As a measure of intrarenal renin activity, we have examined renal plasma flow (RPF) responses in a standardized protocol. Compared with responses with angiotensin-converting enzyme inhibition (rise in RPF ≈95 mL · min⁻¹ · 1.73 m⁻²), greater renal vasodilation with angiotensin receptor blockers (≈145 mL · min⁻¹ · 1.73 m⁻²) suggested more effective blockade. We predicted that blockade with the direct oral renin inhibitor aliskiren would produce renal vascular responses exceeding those induced by angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.