Kokoam nhyehyɛe bi a ɛhwɛ yɛn mogya mmoroso so: Ne nyinaa fa Renin ho!

So woasusuw nneɛma a ɛyɛ nwonwa pii a ɛkɔ so wɔ yɛn nipadua mu no ho pɛn? Ɛtɔ mmere bi a, a yennim mpo no, nneɛma a ɛyɛ nwonwa pii wɔ hɔ a ɛma yɛn nipadua nya apɔwmuden. Sɛ nhwɛso no, nea ɛboa ma yɛhyɛ yɛn mogya mmoroso no, wɔfrɛ no Renin. Ɛnnɛ, momma yɛnka nea Renin yɛ, sɛnea ɛyɛ adwuma, ne sɛnea ɛho hia ma yɛn akwahosan ho asɛm.

Dɛn ne Renin? Sɛ yɛbɛka no tiawa a...

Okay, afei momma yɛnhwɛ nea saa renin yi yɛ. Sɛ yɛbɛka no tiawa a, renin yɛ enzyme bi a nkwammoaa titiriw bi a ɛwɔ w’asaabo mu na ɛyɛ. Nsuro enzyme bi, ɛyɛ protein a ɛboa ma nnuru ahorow kɔ yɛn nipadua mu ntɛmntɛm.

Saa guy a wɔfrɛ no renin yi nko ara nnyɛ adwuma. Ɔka adwinnade kɛse bi a wɔfrɛ no renin-angiotensin-aldosterone nhyehyɛe (RAAS) ho. Ɛte sɛ nkɔnsɔnkɔnsɔn a wɔde yɛ ade. Nhyehyɛe yi nyinaa atirimpɔw titiriw ne sɛ ɛbɛma wo mogya mmoroso ayɛ nea ɛfata. Ne titiriw no, renin di hormone bi a wɔfrɛ no aldosterone a yɛn adrenal glands (ntini nketewa a ɛwɔ asaabo atifi) na ɛyɛ no so.

Enti, ɔkwan bɛn so na Renin yi yɛ adwuma?

Afei ɔfã a ɛho hia no ni. Renin adwuma titiriw ne sɛ ɔbɛhwɛ mogya mmoroso so. Ɛne hormone afoforo abien a ɛho hia a wɔfrɛ no angiotensin ne aldosterone bom yɛ eyi. Sɛ wɔka saa abiɛsa yi bom a, ɛboa ma wo nipadua mu sodium (nkyene) ne potassium dodow kɔ so yɛ nea ɛfata.

Fa no sɛ eyi rekɔ so:

1. Nea edi kan no, renin dan angiotensinnogen (aduru a edi angiotensin anim) a wo mmerɛbo yɛ no ma ɛbɛyɛ angiotensin I ( angiotensin, hormone bi a ɛma wo mogya ntini yɛ teateaa).

2. Afei, saa angiotensin I yi dan angiotensin II .

3. Afei saa angiotensin II yi ne adwumayɛ pɔnkɔ ankasa. Ɛma wo mogya ntini no yɛ teateaa na ɛboa nso ma hormone aldosterone no fi mu.

4. Nea etwa to no, saa aldosterone yi boa ma w’asaabo ma nsu ne nkyene (sodium) kɔ wo nipadua mu. Eyi ma nsu dodow a ɛwɔ wo nipadua mu no yɛ kɛse. Eyi na ɛma wo mogya mmoroso kɔ soro.

Sɛ yɛbɛka no tiawa a, sɛ mogya mmoroso so tew a, ɔbarima bi a wɔfrɛ no renin ba mu, fa nnipa kakraa bi bio, ɔtwetwe mogya ntini bi, ɔkora nsu bi so wɔ nipadua no mu, na ɔma mogya mmoroso san ba sɛnea na ɛte kan no.

Ɔkwan bɛn so na wɔde renin sie? Bere bɛn na?

Okay, afei wowɔ asɛmmisa bi: so wɔyɛ saa renin yi wɔ nipadua no mu ara kwa, anaasɛ woyi fi adi wɔ mmere pɔtee bi mu? Renin pue kɔ wo mogya mu bere a wo mogya so tew dodo, anaasɛ bere a sodium (nkyene) a ɛdɔɔso afi wo nipadua mu no ayera no.

Ne titiriw no, nneɛma a edidi so yi ka renin a wɔde sie no:

• Baroreceptors (eyinom yɛ pressure-sensitive receptors) a ɛwɔ wo mogya ntini mu no te mogya mmoroso nka.
• Sɛ w’asaabo hu nkyene (sodium) a ɛba fam wɔ wo nipadua mu a.
• Beta 1 adrenergic receptors a ɛhwɛ wo koma bɔ so no te dwumadi a ɛwɔ wo tema ntini mu no nka (eyi ba bere a yɛayɛ basaa anaasɛ yesuro no).

So renin nkutoo ma mogya mmoroso yɛ kɛse?

Dabi, ɛnyɛ pɛpɛɛpɛ. Renin nkutoo nnya wo mogya so nkɛntɛnso. Mmom no, sɛnea wadi kan aka no, ɛne angiotensin ne aldosterone bom yɛ adwuma. Angiotensin ma wo mogya ntini no yɛ teateaa, na aldosterone boa ma w’asaabo ma nsu ne nkyene kɔ so tra hɔ. Eyi ne nea ɛma wo nipadua no kura nsu pii na ɛma wo mogya mmoroso kɔ soro.

Ɛhe na wɔyɛ renin?

Ebia wunim eyi mprempren. Wɔyɛ renin wɔ w’asaabo mu. Sɛ wo systolic mogya mmoroso (dodow a ɛwɔ soro bere a woresusuw mogya mmoroso) so tew, anaasɛ w’asaabo te nka sɛ nsu nni wo nipadua mu a, ɛma renin kɔ wo mogya mu.

Dɛn na wɔde yɛ renin? (Eyi yɛ nyansahu mu asɛm kakra, nanso ɛfata sɛ wuhu.)

Eyi yɛ asɛm a emu dɔ kakra, nanso sɛ yɛbɛka no tiawa a, renin wɔ amino acid nkae bɛyɛ 340. Amino acid te sɛ nneɛma nketenkete a wɔde si protein ahorow no. Eyinom bom yɛ enzyme a wɔfrɛ no renin. Ɛte sɛ birikisi pii a wɔaka abom ayɛ ɔfasu.

Ayaresa mu tebea horow bɛn na ebia ɛne renin a wɔyɛ no wɔ abusuabɔ?

Ɛtɔ mmere bi a, renin dodow betumi akɔ soro wɔ nipadua no mu. Nneɛma a ɛte sɛ eyinom betumi de aba:

• Mogya mmoroso a ɛba fam (Hypotension) .
• Sɛ woahwere mogya pii (e.g. efi akwanhyia mu).
• Sɛ w'asaabo so atew mogya a ɛkɔ mu no so a .
• Volume depletion (e.g., nsu a ɛtɔ esiane ɔfe anaa yafunu a ɛyɛ yaw nti).
• Ntini a ɛma obi nya tema no dwumadi a ɛkɔ soro (Sympathetic nerve activation) (wɔ eyi mu no, koma no bɔ, ɔhome a ɛbɔ, mogya mmoroso kɔ soro, na aniwa no mu kurukuruwa tuntum no yɛ kɛse).

So sɔhwɛ ahorow bi wɔ hɔ a wɔde hwɛ sɛnea renin dodow te?

Yiw, koraa. Wo duruyɛfo betumi ayɛ renin dwumadi ho nhwehwɛmu ne aldosterone dodow ho nhwehwɛmu. Eyi bɛma wahu aldosterone dodow a wo adrenal glands no reyɛ.

Sɛ wowɔ mogya mmoroso, titiriw sɛ nnuru a wotaa de di dwuma no ntumi nni so a, ebia wo duruyɛfo bɛhyɛ sɛ wɔnyɛ nhwehwɛmu yi.Ebia wowɔ tebea bi a wɔfrɛ no primary aldosteronism (PA) (a wɔsan frɛ no Conn’s syndrome) . Wɔ tebea yi mu no, wɔyɛ aldosterone pii dodo, na ɛma mogya mmoroso ba. Renin nhwehwɛmu betumi aboa ma woahu sɛ ebia PA na ɛde wo mogya mmoroso ba anaa.

Ɔkwan bɛn so na wɔsusuw renin?

Wɔtaa de biribi a wɔfrɛ no plasma renin dwumadi (PRA) susuw renin . Eyi kyerɛ sɛnea renin reyɛ angiotensin I (nea edi angiotensin II anim) yiye. Wobetumi asusuw nso sɛ renin tẽẽ .

Sɛ wo renin dodow kɔ soro a, dɛn na ɛkyerɛ?

Sɛ wo renin dodow dɔɔso a, ebetumi afi:

• Addison yareɛ (baabi a wo adrenal glands ntumi nyɛ hormone a ɛdɔɔso) - titire no sɛ nipadua mu nsuo so tew.
• Dehydration (nsu a enni nipadua no mu).
• Potassium dodow a ɛba fam wɔ mogya mu (hypokalemia) .
• Mogya a ɛtɔ (mogya pii a ɛsen kɔ akwaa bi mu anaa akyi).
• Asaabo mu akisikuru a ɛma renin .
• Renal hypertension (mogya mmoroso a ɛnam mogya ntini a ɛkɔ asaabo no mu a ɛyɛ teateaa so na ɛba).
• Malignant hypertension (eyi yɛ mogya mmoroso a ɛba mpofirim, a wɔmfa kɔkɔbɔ biara mma ).
• Primary hypertension (eyi yɛ mogya mmoroso a ɛnyɛ nea efi aduruyɛ mu tebea foforo mu ba).
• Koma a entumi nyɛ adwuma yiye anaasɛ mmerɛbo no mu yare (bere a nipadua no mogya dodow a ɛyɛ adwuma no so tew bere a tebea horow yi ba no).

Na sɛ renin dodow no sua nso ɛ?

Nneɛma bi nso wɔ hɔ a enti ebia renin dodow bɛkɔ fam. Nhwɛsoɔ:

• Aldosteronism titiriw (PA) .
• Sɛ wode nnuru a ɛma nkyene kɔ nipadua no mu redi dwuma a.
• Nkyene-sensitive hypertension (nnipa binom wɔ mogya mmoroso bere mpo a wodi nkyene dodo kakra no, ɛno yɛ tebea).

Mɛyɛ dɛn atumi ama me renin dodow akɔ so ayɛ nea ɛfata?

Sɛ wo renin dodow kɔ soro anaasɛ ɛba fam wɔ ɔkwan a ɛnteɛ so a, wo duruyɛfo no bɛkyerɛ nea ɛde ba no na wayɛ ayaresa ho nhyehyɛe. Wɔrenkyerɛw nnuru a wɔde bɛma wo renin no akɔ fam anaasɛ ama akɔ soro kɛkɛ.

Sɛ nhwɛso no, sɛ renin dodow a ɛkɔ soro ne mogya mmoroso a, wo duruyɛfo betumi akyerɛw wo nnuru a ɛma mogya mmoroso te sɛ beta-blockers ne clonidine .

Awiei koraa no, nea ɛsɛ sɛ wokae (Take-Home Message) .

Enti, renin nyɛ enzyme bi kɛkɛ. Ɛyɛ renin-angiotensin-aldosterone nhyehyɛe (RAAS) no fã a ɛho hia yiye. Ɛdi dwuma kɛse wɔ wo mogya mmoroso a wobɛma ayɛ yiye no mu.

Nneɛma ahorow betumi ama wo renin dodow yɛ nea ɛnteɛ. Enti sɛ w’adwene mu yɛ wo naa a, nea eye sen biara ne sɛ wobɛkɔ oduruyɛfo nkyɛn, ahu nea ɛde ba ankasa, na woanya ayaresa a ɛho hia. Mfa wo gut feeling nkɔ kɛkɛ, efisɛ saa nneɛma yi yɛ den kakra.

Wo duruyɛfo betumi aboa wo pɛpɛɛpɛ. Kɔ so nya apɔwmuden!

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