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Renin-Angiotensin-Aldosterone Pathway

Jul 25, 2025

Overview

This lecture explains the renin-angiotensin-aldosterone pathway, the roles of aldosterone and antidiuretic hormone (ADH) in regulating water, sodium, and potassium balance, and how the kidneys help control blood pressure, osmolarity, and pH.

Renin-Angiotensin-Aldosterone Pathway

  • Granular cells in the juxtaglomerular apparatus release renin near the afferent arteriole.
  • Renin converts angiotensinogen (from the liver) to angiotensin I in the bloodstream.
  • Angiotensin I is converted to angiotensin II by angiotensin-converting enzyme (ACE) in the lungs.
  • Angiotensin II constricts the efferent arteriole and stimulates the adrenal glands to release aldosterone.
  • ACE inhibitors block the conversion of angiotensin I to angiotensin II.

Role of Aldosterone

  • Aldosterone is released from the adrenal gland in response to angiotensin II or high potassium levels in the blood.
  • It acts on distal convoluted tubule and collecting duct cells to increase the number of sodium-potassium pumps.
  • These pumps move sodium into the interstitial fluid and potassium into the urine.
  • More sodium in the interstitial fluid increases osmolarity, causing water to follow and be reabsorbed.
  • Aldosterone helps to conserve water, increases blood pressure, and allows the body to excrete excess potassium.

Role of Antidiuretic Hormone (ADH)

  • ADH is made in the hypothalamus and released from the posterior pituitary when blood osmolarity is high (dehydration).
  • ADH increases the number of water channels (aquaporins) in the distal tubules and collecting ducts.
  • This action promotes water reabsorption, concentrating urine and preserving body water.
  • ADH works independently or together with aldosterone for water conservation.

Kidney Regulation of pH and Other Functions

  • Intercalated cells in the nephron secrete protons (H⁺) into the filtrate to help regulate blood pH.
  • The kidneys also remove nitrogenous wastes and secrete erythropoietin to stimulate red blood cell production.

Key Terms & Definitions

  • Renin — an enzyme released by kidney granular cells that initiates the renin-angiotensin-aldosterone pathway.
  • Angiotensin II — a hormone that constricts vessels and stimulates aldosterone release.
  • Aldosterone — a hormone from the adrenal gland that increases sodium reabsorption and potassium excretion in the kidney.
  • Antidiuretic Hormone (ADH) — a hormone that increases water reabsorption by adding water channels to kidney tubule cells.
  • Osmolarity — concentration of solutes in a solution; higher osmolarity means less water.
  • Juxtaglomerular Apparatus — a kidney structure involved in blood pressure regulation.
  • Intercalated Cells — nephron cells that assist in acid-base balance by secreting hydrogen ions.

Action Items / Next Steps

  • Review the steps and hormone actions in the renin-angiotensin-aldosterone pathway.
  • Understand how aldosterone and ADH individually and together regulate urine concentration.
  • Learn key definitions and kidney cell types involved in electrolyte and pH balance.