Renal secretion of inactive renin.

Human plasma contains a non-dialyzable factor which is not enzymatically active in its native form but shows renin-like activity after exposure to low pH (inactive renin). In 3 out of 13 patients with renovascular hypertension the renal to peripheral vein ratio for inactive renin on the affected side was above 1.40, indicating renal release of this form of renin. In 4 cases a high renal to peripheral vein ratio for active renin was associated with a ratio for inactive renin below 0.80, indicating renal activation of circulating inactive renin. The results suggest a renal mechanism for modulating the degree of activation of renin. They have some practical implications for the pre-operative evaluation of patients with renovascular hypertension.