Vitamin D increases plasma renin activity independently of plasma Ca super(2+) via hypovolemia and beta -adrenergic activity

• Published in: American journal of physiology. Renal physiology 2013-10, Vol.305 (8), p.F1109-F1109
• Main Authors: Atchison, Douglas K, Harding, Pamela, Beierwaltes, William H
• Format: Article
• Language: English
• ISSN: 1931-857X; 1522-1466

1, 25-Dihydroxycholechalciferol (calcitriol) and 19-nor-1, 25-dihydroxyvitamin D2 (paricalcitol) are vitamin D receptor (VDR) agonists. Previous data suggest VDR agonists may actually increase renin-angiotensin activity, and this has always been assumed to be mediated by hypercalcemia. We hypothesized that calcitriol and paricalcitol would increase plasma renin activity (PRA) independently of plasma Ca2+ via hypercalciuria-mediated polyuria, hypovolemia, and subsequent increased beta -adrenergic sympathetic activity. We found that both calcitriol and paricalcitol increased PRA threefold (P < 0.01). Calcitriol caused hypercalcemia, but paricalcitol did not. Both calcitriol and paricalcitol caused hypercalciuria (9- and 7-fold vs. control, P < 0.01) and polyuria (increasing 2.6- and 2.2-fold vs. control, P < 0.01). Paricalcitol increased renal calcium-sensing receptor (CaSR) expression, suggesting a potential cause of paricalcitol-mediated hypercalciuria and polyuria. Volume replacement completely normalized calcitriol-stimulated PRA and lowered plasma epinephrine by 43% (P < 0.05). beta -Adrenergic blockade also normalized calcitriol-stimulated PRA. Cyclooxygenase-2 inhibition had no effect on calcitriol-stimulated PRA. Our data demonstrate that vitamin D increases PRA independently of plasma Ca2+ via hypercalciuria, polyuria, hypovolemia, and increased beta -adrenergic activity.