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Hydronephrosis RAAS Renin : - Secretion : disekresi oleh Juxtaglomerular apparatus (granular cell) oleh 3 stimuli o A decrease in arterial blood pressure (that could be related to a decrease in blood volume) as detected by baroreceptors (pressure-sensitive cells) o A decrease in sodium load delivered to the distal tubule. This load is measured by the macula densa of the juxtaglomerular apparatus. o Sympathet
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  Hydronephrosis    RAAS  Renin : -   Secretion : disekresi oleh Juxtaglomerular apparatus (granular cell) oleh 3 stimuli o   A decrease in arterial blood pressure (that could be related to a decrease in blood volume) as detected by baroreceptors (pressure-sensitive cells) o   A decrease in sodium load delivered to the distal tubule. This load is measured by the macula densa of the juxtaglomerular apparatus. o   Sympathetic nervous system activity, which also controls blood pressure, acting through the β1 adrenergic receptors. Angiotensin I : -   Angiotensin I appears to have no direct biological activity and exists solely as a precursor to angiotensin II. Angiotensin II : RENAL HORMONES  Main : -   erythropoietin -   calcitriol (1,25- dihydroxycholecalciferol ) -   renin Other : -   They also synthesize prostaglandins, which affect many processes in the kidneys . -   In addition to synthesis , the kidneys also contribute to the degradation of certain hormones  –  such as insulin (forms insulinase  –  cleaves insulin) or parathyroid hormone. Erythropoietin (EPO)  -   Merupakan glycoprotein -   Berikatan dengan receptor di permukaan membrane precursor of RBC -   Saat berikatan, erythropoietin mengurangi apoptosis dari precursor RBC, dan meningkatkan masa hidup sehingga bisa matang menjadi RBC -   Disintesis 90% di ginjal (interstitial cell) dan sisanya di liver (perivenous hepatocytes) -   Saat fetal period produksi utama di liver -   BISA JADI DOPING SUBSTANCE DI ATLET (recombinant EPO) -   Produksinya distimulasi dari decrease in the partial oxygen pressure dari kidney dan liver -   Inaktifasinya di liver  Calcitriol (1,25  –  dihydroxycholecalciferol) / Vitamin D3  -   Disintesis dari kulit yang terpapar sinar UV-B ataupun dari makanan (provitamin D) -   7 dehydrocholesterol akan berubah menjadi cholecalciferol setelah paparah dari sinar UV-B di kulit   cholecalciferol / calciferol akan diubah menjadi calcidiol (25  –  hydroxycholecalciferol) di liver oleh enzyme Vitamin D3 -25- hydroxylase   lalu calcidiol akan diubah menjadi calcitriol (1,25  –  dihydroxycholecalciferol) di kidney dengan enzyme 25 hydroxy D3 1 alpha hydroxylase -   Action : -   Calcitriol stimulates the small intestine for protein synthesis allowing absorption of Ca2+ and phosphates. -   This ensures the availability of Ca2+ and phosphate for bone growth. -   Calcitriol simultaneously activates osteoblasts to synthesize collagen.
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