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Renin Angiotensin System (RAS)
Jefri Pratama Susanto
Fakultas Kedokteran Universitas Brawijaya, Malang, Indonesia
ABSTRAK
Peran renin angiotensin system (RAS) dalam patofisiologi hipertensi sudah diketahui sejak lama. Produk akhir RAS, yaitu angiotensin II
menyebabkan hipertensi, sehingga digunakan obat angiotensin converting enzyme inhibitor (ACE-I) untuk menghambat pembentukan
angiotensin II. Namun, beberapa penelitian menunjukkan bahwa pada penggunaan ACE-I terus-menerus dengan dosis efektif, kadar
angiotensin II tetap tidak berkurang, sehingga muncul pemahaman baru, yaitu angiotensin II dapat terbentuk tanpa melalui ACE yang
disebut sebagai jalur non-ACE. Studi baru menemukan bahwa RAS juga memiliki efek nefro-protektif dan kardio-protektif melalui ACE-2.
Kata kunci: ACE, ACE-2, angiotensin II, jalur non-ACE
ABSTRACT
It is well established that renin angiotensin system (RAS) contributes to the hypertension pathophysiology. The end product, which is
angiotensin II can cause hypertension, and angiotensin converting enzyme inhibitor (ACE-I) is used to inhibit angiotensin II production.
However, several studies show that regular use of ACE-I with effective dose did not decrease angiotensin II level. This leads to a new
concept that angiotensin II can be synthesized through non-ACE pathway. Recent studies find that RAS also has reno-protective and cardioprotective effect through ACE-2. Jefri Pratama Susanto. New Concepts of Renin Angiotensin System (RAS).
Keywords: ACE, ACE-2, angiotensin II, non-ACE pathway
PENDAHULUAN
Peranan renin-angiotensin system (RAS)
dalam homeostasis sistem kardiovaskuler,
tekanan darah, serta keseimbangan cairan
dan elektrolit sudah diketahui sejak lama.
Aktivasi sistem ini secara terus-menerus
akan membentuk angiotensin II. Angiotensin
II dapat menyebabkan vasokonstriksi, peningkatan aldosteron, dan retensi cairan
yang akhirnya akan menimbulkan hipertensi.
Angiotensin II terbentuk dari angiotensin I
dibantu oleh angiotensin converting enzyme
(ACE), sehingga salah satu pengobatan
hipertensi adalah menghambat ACE dengan
menggunakan angiotensin converting enzyme
inhibitor (ACE-I).
Secara teori ACE-I berfungsi menghambat
pembentukan angiotensin II, namun penelitian pada pasien hipertensi yang menggunakan ACE-I secara terus-menerus dengan
dosis efektif, menunjukkan bahwa kadar
Alamat korespondensi
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email: j3ff_12y@yahoo.com
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Gambar 2. Renin Angiotensin System (RAS), enzim lain yang berperan dalam pembentukan angiotensin II
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