juxtaglomerular apparatus


Summary: A complex of cells consisting of juxtaglomerular cells, extraglomerular mesangium lacis cells, the macula densa of the distal convoluted tubule, and granular epithelial peripolar cells. Juxtaglomerular cells are modified SMOOTH MUSCLE CELLS found in the walls of afferent glomerular arterioles and sometimes the efferent arterioles. Extraglomerular mesangium lacis cells are located in the angle between the afferent and efferent glomerular arterioles. Granular epithelial peripolar cells are located at the angle of reflection of the parietal to visceral angle of the renal corpuscle.

Top Publications

  1. Shao L, Manalang M, Cooley L. Juxtaglomerular cell tumor in an 8-year-old girl. Pediatr Blood Cancer. 2008;50:406-9 pubmed
    ..It is considered a benign tumor arising from the juxtaglomerular apparatus of the kidney...
  2. Markey R, MacLennan G. Juxtaglomerular cell tumor of the kidney. J Urol. 2006;175:730 pubmed
  3. Lin S, Liu W, Chen W, Chen R. Secondary hypertension due to a renin-secreting juxtaglomerular cell tumor. J Formos Med Assoc. 2010;109:237-40 pubmed publisher
    ..Hypertension and hypokalemia completely resolved postoperatively. JCT should be considered when investigating hypertensive individuals with high plasma renin activity. ..
  4. Dong D, Li H, Yan W, Xu W, Lu L, Zeng Z. The diagnosis and surgical management of juxtaglomerular cell tumor of the kidney. J Hypertens. 2010;28:628-32 pubmed publisher
    ..JCT of the kidney should be kept in mind because they represent a surgically curable cause of secondary hypertension. Nephron-sparing surgery is recommended. ..
  5. Schricker K, Kurtz A. Role of membrane-permeable ions in renin secretion by renal juxtaglomerular cells. Am J Physiol. 1995;269:F64-9 pubmed
  6. Kim H, Kim C, Choi Y, Ayala A, Amirikachi M, Ro J. Juxtaglomerular cell tumor of kidney with CD34 and CD117 immunoreactivity: report of 5 cases. Arch Pathol Lab Med. 2006;130:707-11 pubmed
    ..Juxtaglomerular cell tumor should be considered in the diagnosis of any renal tumors with epithelioid cells and negative initial cytokeratin immunohistochemistry. ..
  7. Troxell M, Scandling J, Sibley R. Renal juxtaglomerular apparatus hyperplasia. Nephrol Dial Transplant. 2005;20:2282-3 pubmed
  8. Ng S, Tan P, Chuah K, Cheng C, Tan J. A case of juxtaglomerular cell tumor associated with membranous glomerulonephritis. Ann Diagn Pathol. 2003;7:314-20 pubmed
    ..This report also highlights the recently described observation of CD34 positivity in juxtaglomerular cell tumors...
  9. Beaudoin J, Perigny M, Tetu B, Lebel M. A patient with a juxtaglomerular cell tumor with histological vascular invasion. Nat Clin Pract Nephrol. 2008;4:458-62 pubmed publisher
    ..Juxtaglomerular cell tumor with vascular invasion. Radical nephrectomy, and follow-up visits to monitor blood pressure and renin levels. ..

More Information


  1. Tanabe A, Naruse M, Ogawa T, Ito F, Takagi S, Takano K, et al. Dynamic computer tomography is useful in the differential diagnosis of juxtaglomerular cell tumor and renal cell carcinoma. Hypertens Res. 2001;24:331-6 pubmed
    ..The present results suggest that the dynamic CT scan is useful in the differential diagnosis of the JG cell tumor and RCC. ..
  2. Min K, Kwon H, Ahn S, Chang S, Chang Y, Bang B, et al. Juxtaglomerular cell tumor of the kidney: a case report. J Korean Med Sci. 2001;16:233-6 pubmed
    ..The immunostaining for renin showed strong positivity in the cytoplasm of tumor cells. The characteristic rhomboid shaped renin protogranules were observed in ultrastructural analysis. ..
  3. Friis U, Jensen B, Aas J, Skøtt O. Direct demonstration of exocytosis and endocytosis in single mouse juxtaglomerular cells. Circ Res. 1999;84:929-36 pubmed
    ..Renin release induced by the cAMP pathway and by cell swelling is exocytotic, and high-intracellular cAMP levels activate membrane retrieval mechanisms. ..
  4. Capovilla M, Couturier J, Molinie V, Amsellem Ouazana D, Priollet P, Baumert H, et al. Loss of chromosomes 9 and 11 may be recurrent chromosome imbalances in juxtaglomerular cell tumors. Hum Pathol. 2008;39:459-62 pubmed publisher
    ..Future clinicopathologic and genomic studies of large retrospective and prospective series may help to better understand the biology of this fascinating entity. ..
  5. Hasegawa A. Juxtaglomerular cells tumor of the kidney: a case report with electron microscopic and flow cytometric investigation. Ultrastruct Pathol. 1997;21:201-8 pubmed
  6. Duan X, Bruneval P, Hammadeh R, Fresco R, Eble J, Clark J, et al. Metastatic juxtaglomerular cell tumor in a 52-year-old man. Am J Surg Pathol. 2004;28:1098-102 pubmed
    Juxtaglomerular cell tumor is a rare renal neoplasm arising from the juxtaglomerular apparatus. Approximately 70 cases have been reported in the English literature since it was first described by Robertson et al in 1967...
  7. Sequeira Lopez M, Pentz E, Nomasa T, Smithies O, Gomez R. Renin cells are precursors for multiple cell types that switch to the renin phenotype when homeostasis is threatened. Dev Cell. 2004;6:719-28 pubmed
  8. Ortiz Capisano M, Ortiz P, Harding P, Garvin J, Beierwaltes W. Decreased intracellular calcium stimulates renin release via calcium-inhibitable adenylyl cyclase. Hypertension. 2007;49:162-9 pubmed
    ..Thus, decreased intracellular calcium stimulates adenylyl cyclase, resulting in cAMP synthesis and, consequently, renin release. ..
  9. Gulmann C, Osterby R, Bangstad H, Rudberg S. The juxtaglomerular apparatus in young type-1 diabetic patients with microalbuminuria. Effect of antihypertensive treatment. Virchows Arch. 2001;438:618-23 pubmed
    Our goal was to investigate the effect of antihypertensive drugs on the juxtaglomerular apparatus (JGA) in young type-1 diabetic patients with microalbuminuria...
  10. Beierwaltes W. The role of calcium in the regulation of renin secretion. Am J Physiol Renal Physiol. 2010;298:F1-F11 pubmed publisher
    ..While calcium does not directly control renin secretion, increased calcium inhibits and decreased calcium amplifies cAMP-stimulated renin secretion. ..
  11. Kuten A, Olumi A, Goldsmith J, Monahan Earley R, Dvorak A, Genega E. Pathologic quiz case. A symptomatic renal tumor. Juxtaglomerular cell tumor. Arch Pathol Lab Med. 2004;128:e112-4 pubmed
  12. Ortiz Capisano M, Ortiz P, Harding P, Garvin J, Beierwaltes W. Adenylyl cyclase isoform v mediates renin release from juxtaglomerular cells. Hypertension. 2007;49:618-24 pubmed
  13. Libório A, Marques F, Testagrossa L, Leite C, Leitão A, Praxedes J. Malignant hypertension with intestinal ischemia secondary to juxtaglomerular cell tumor. Am J Kidney Dis. 2005;46:957-61 pubmed
    ..We believe this is the first case of juxtaglomerular cell tumor causing malignant hypertension. The diagnostic approach and treatment are discussed. ..
  14. Chambô J, Falci Júnior R, Lucon A. Juxtaglomerular cell tumor as a rare cause of hypertension in adults. Int Braz J Urol. 2004;30:119-20 pubmed
    ..Partial nephrectomy was performed and the postoperatory was uneventful. Normalization of blood pressure was observed within the first month. ..
  15. Peti Peterdi J, Fintha A, Fuson A, Tousson A, Chow R. Real-time imaging of renin release in vitro. Am J Physiol Renal Physiol. 2004;287:F329-35 pubmed
    ..Fluorescence microscopy is an excellent tool for the further study of the mechanism, regulation, and dynamics of renin release. ..
  16. Gottardo F, Cesari M, Morra A, Gardiman M, Fassina A, Dal Bianco M. A kidney tumor in an adolescent with severe hypertension and hypokalemia: an uncommon case--case report and review of the literature on reninoma. Urol Int. 2010;85:121-4 pubmed publisher
    ..The conservative surgical management is the gold standard for small, circumscribed lesions. ..
  17. Dong D, Li H, Yan W, Xu W. Juxtaglomerular cell tumor of the kidney--a new classification scheme. Urol Oncol. 2010;28:34-8 pubmed publisher
    ..JCT of the kidney should be considered in patients with hypertension and renal tumor, and nephron-sparing surgery is the first choice. ..
  18. Martin S, Mynderse L, Lager D, Cheville J. Juxtaglomerular cell tumor: a clinicopathologic study of four cases and review of the literature. Am J Clin Pathol. 2001;116:854-63 pubmed
    ..There were no recurrences or metastases. The characteristic clinical and morphologic features of juxtaglomerular cell tumor permit distinction from renal hemangiopericytoma and other renal tumors. ..
  19. Hanner F, von Maltzahn J, Maxeiner S, Toma I, Sipos A, Krüger O, et al. Connexin45 is expressed in the juxtaglomerular apparatus and is involved in the regulation of renin secretion and blood pressure. Am J Physiol Regul Integr Comp Physiol. 2008;295:R371-80 pubmed publisher
    ..Previous studies have identified several connexin isoforms in the juxtaglomerular apparatus (JGA), but the vascular connexin isoform Cx45 has not yet been studied in this region...
  20. Lachvac L, Svajdler M, Valansky L, Nagy V, Benicky M, Frohlichova L, et al. Juxtaglomerular cell tumor, causing fetal demise. Int Urol Nephrol. 2011;43:365-70 pubmed publisher
    ..No staining in early phase of contrast CT is the feature that differentiates JGCT from renal cell carcinoma. These tumors are benign, with only one reported exception, and nephron-sparing surgery is preferable. ..
  21. Kong J, Qiao G, Zhang Z, Liu S, Li Y. Targeted vitamin D receptor expression in juxtaglomerular cells suppresses renin expression independent of parathyroid hormone and calcium. Kidney Int. 2008;74:1577-81 pubmed publisher
    ..Our study shows that suppression of renin expression by 1,25-dihydroxyvitamin D in vivo is independent of parathyroid hormone and calcium. ..
  22. Bruneval P, Fournier J, Soubrier F, Belair M, da Silva J, Guettier C, et al. Detection and localization of renin messenger RNA in human pathologic tissues using in situ hybridization. Am J Pathol. 1988;131:320-30 pubmed
    ..In ischemic kidneys, the cells containing both renin mRNA and renin protein were found in numerous juxtaglomerular apparatus and in the wall of arterioles, shown by combined in situ hybridization and immunohistochemistry...
  23. Brandal P, Busund L, Heim S. Chromosome abnormalities in juxtaglomerular cell tumors. Cancer. 2005;104:504-10 pubmed
    ..Gain of chromosome 10, as well as loss of chromosomes 9 and X and most of chromosome arm 11q, might be important pathogenetic events in JGCT. ..
  24. Rosivall L, Mirzahosseini S, Toma I, Sipos A, Peti Peterdi J. Fluid flow in the juxtaglomerular interstitium visualized in vivo. Am J Physiol Renal Physiol. 2006;291:F1241-7 pubmed
    Earlier electron microscopy studies demonstrated morphological signs of fluid flow in the juxtaglomerular apparatus (JGA), including fenestrations of the afferent arteriole (AA) endothelium facing renin granular cells...
  25. Thomson S, Bachmann S, Bostanjoglo M, Ecelbarger C, Peterson O, Schwartz D, et al. Temporal adjustment of the juxtaglomerular apparatus during sustained inhibition of proximal reabsorption. J Clin Invest. 1999;104:1149-58 pubmed
    ..Tubular transport measurements confirmed that BNZ affected TGF within the juxtaglomerular apparatus. During reduced proximal reabsorption, TGF resets to accommodate increased flow and SNGFR through a ..
  26. Bell P, Lapointe J, Peti Peterdi J. Macula densa cell signaling. Annu Rev Physiol. 2003;65:481-500 pubmed
    ..The adaptation of multi-photon microscopy is providing new insights into macula densa-glomerular signaling. ..
  27. Morris B. Fluorescence activated cell sorting of transiently transfected As4.1 cells shows renin enhancer directs on/off switching of renin promoter in vitro. Clin Exp Pharmacol Physiol. 2008;35:367-71 pubmed publisher
    ..Limitations of these findings are discussed. ..
  28. Liu R, Persson A. Angiotensin II stimulates calcium and nitric oxide release from Macula densa cells through AT1 receptors. Hypertension. 2004;43:649-53 pubmed
    ..In conclusion, we found that Ang II increased [Ca(2+)](i) and stimulated NO production in MD cells from the basolateral and luminal sides through AT(1) receptors. ..
  29. Liu S, Plachez C, Shao Z, Puche A, Shipley M. Olfactory bulb short axon cell release of GABA and dopamine produces a temporally biphasic inhibition-excitation response in external tufted cells. J Neurosci. 2013;33:2916-26 pubmed publisher
    ..GABA and DA cotransmission from SACs to ETCs may play a key role in regulating output coding across the glomerular array...
  30. Kim Y, Lee S, Kim S, Lee A, Moon J, Jeong K, et al. Sequential activation of the intrarenal renin-angiotensin system in the progression of hypertensive nephropathy in Goldblatt rats. Am J Physiol Renal Physiol. 2016;311:F195-206 pubmed publisher
    ..At 2w, juxtaglomerular apparatus (JGA) and collecting duct (CD) renin increased in clipped kidney (CK) of 2K1C rats...
  31. Kirkham A, Ho S, Paterson R, Johnson M, Chang S. Treatment of a juxtaglomerular tumour with radiofrequency ablation. Urology. 2008;71:168.e1-4 pubmed publisher
    ..Because the tumors are usually small at presentation, and there are good markers for recurrence, we consider treatment by radiofrequency ablation a useful alternative to nephron-sparing surgery and describe its use in one patient. ..
  32. Iijima K, Hamahira K, Kobayashi A, Nakamura H, Yoshikawa N. Immunohistochemical analysis of renin activity in chronic cyclosporine nephropathy in childhood nephrotic syndrome. J Am Soc Nephrol. 2000;11:2265-71 pubmed
    ..to renin was detected mainly in those parts of arterioles within the anatomically well-defined juxtaglomerular apparatus. In the post-CyA specimens, it was also detected in those parts of the vessels upstream from the ..
  33. Pentz E, Moyano M, Thornhill B, Sequeira Lopez M, Gomez R. Ablation of renin-expressing juxtaglomerular cells results in a distinct kidney phenotype. Am J Physiol Regul Integr Comp Physiol. 2004;286:R474-83 pubmed
    ..We conclude that renin cells per se are necessary for the morphological integrity of the kidney and may have a role in maintenance of normal kidney function. ..
  34. Gavrilov J, Bernardini S, Leogite J, Viennet G, Wallerand H, Bittard H. [Tumor of the juxtaglomerular apparatus]. Prog Urol. 2002;12:700-2 pubmed
  35. Della Bruna R, Pinet F, Corvol P, Kurtz A. Opposite regulation of renin gene expression by cyclic AMP and calcium in isolated mouse juxtaglomerular cells. Kidney Int. 1995;47:1266-73 pubmed
    ..Moreover, in these acute experiments there appears to be no obligatory link between the secretion and the expression of renin, suggesting that both parameters are separately regulated. ..
  36. Fernández Fernández B, Ortiz A, Gomez Guerrero C, Barat A, Martín Cleary C, Egido J. Juxtaglomerular apparatus hyperplasia under dual angiotensin blockade. A footprint of adequate RAS inhibition or a concern for renal fibrosis?. BMC Nephrol. 2012;13:21 pubmed
    ..We present a patient with corticoid resistant nephrotic syndrome who developed marked juxtaglomerular apparatus hyperplasia and renin expression in the context of dual angiotensin system blockade...
  37. Gambaryan S, Wagner C, Smolenski A, Walter U, Poller W, Haase W, et al. Endogenous or overexpressed cGMP-dependent protein kinases inhibit cAMP-dependent renin release from rat isolated perfused kidney, microdissected glomeruli, and isolated juxtaglomerular cells. Proc Natl Acad Sci U S A. 1998;95:9003-8 pubmed
    ..Our results indicate that cGK II, and possibly cGK I, can mediate cGMP inhibitory effects on renin release and are physiological components of the cGMP signal transduction system which opposes the RAAS. ..
  38. Neubauer B, Machura K, Chen M, Weinstein L, Oppermann M, Sequeira Lopez M, et al. Development of vascular renin expression in the kidney critically depends on the cyclic AMP pathway. Am J Physiol Renal Physiol. 2009;296:F1006-12 pubmed publisher
  39. Klar J, Vitzthum H, Kurtz A. Aldosterone enhances renin gene expression in juxtaglomerular cells. Am J Physiol Renal Physiol. 2004;286:F349-55 pubmed
    ..In summary, these data suggest that aldosterone exerts a direct positive effect on renin gene expression at the cellular level probably by stabilizing renin mRNA. ..
  40. Liu L, Chen G, Wang P, Zhang Y, Zhang S, Zhang C, et al. [Clinicopathological study of 4 renal juxtaglomerular cell tumors]. Zhonghua Zhong Liu Za Zhi. 2005;27:302-5 pubmed
    ..It has a unique morphology and ultrastructure features and positive immunoreactivity to Vim, Actin, calponin and CD34. ..
  41. Jensen B, Mann B, Skøtt O, Kurtz A. Differential regulation of renal prostaglandin receptor mRNAs by dietary salt intake in the rat. Kidney Int. 1999;56:528-37 pubmed
  42. Bachmann S, Oberbäumer I. Structural and molecular dissection of the juxtaglomerular apparatus: new aspects for the role of nitric oxide. Kidney Int Suppl. 1998;67:S29-33 pubmed
    The juxtaglomerular apparatus (JGA) is composed of the macula densa (MD), the extraglomerular mesangium, and the juxtaglomerular arterioles...
  43. Wagner C, Kurtz A. Distribution and functional relevance of connexins in renin-producing cells. Pflugers Arch. 2013;465:71-7 pubmed publisher
    ..This short review aims to summarize these findings and tries to set them into a functional context. ..
  44. Abe T. [Ectopic renin-producing tumor]. Nihon Rinsho. 2006;Suppl 3:313-6 pubmed
  45. Kim S, Theilig F, Qin Y, Cai T, Mizel D, Faulhaber Walter R, et al. Dense-core vesicle proteins IA-2 and IA-2{beta} affect renin synthesis and secretion through the {beta}-adrenergic pathway. Am J Physiol Renal Physiol. 2009;296:F382-9 pubmed publisher
    ..We conclude that IA-2 and IA-2beta are required to maintain normal levels of renin expression and renin release, most likely by permitting normal rates of catecholamine release from sympathetic nerve terminals. ..
  46. Bie P, Mølstrøm S, Wamberg S. Normotensive sodium loading in conscious dogs: regulation of renin secretion during beta-receptor blockade. Am J Physiol Regul Integr Comp Physiol. 2009;296:R428-35 pubmed publisher
    ..Low-sodium diet augments vasopressin secretion, whereas ANP secretion is reduced. ..
  47. Inaki K, Takahashi Y, Nagayama S, Mori K. Molecular-feature domains with posterodorsal-anteroventral polarity in the symmetrical sensory maps of the mouse olfactory bulb: mapping of odourant-induced Zif268 expression. Eur J Neurosci. 2002;15:1563-74 pubmed
    ..These results suggest that the molecular-feature domain with its fixed polarity is one of the basic structural units in the spatial organization of the odourant receptor maps in the olfactory bulb. ..
  48. Welch W, Tojo A, Wilcox C. Roles of NO and oxygen radicals in tubuloglomerular feedback in SHR. Am J Physiol Renal Physiol. 2000;278:F769-76 pubmed
    ..rat (SHR) has enhanced tubuloglomerular feedback (TGF) responses and diminished buffering by juxtaglomerular apparatus (JGA)-derived nitric oxide (NO) despite enhanced expression of NO synthase (NOS) isoforms in the JGA...
  49. Prieto Carrasquero M, Kobori H, Ozawa Y, Gutierrez A, Seth D, Navar L. AT1 receptor-mediated enhancement of collecting duct renin in angiotensin II-dependent hypertensive rats. Am J Physiol Renal Physiol. 2005;289:F632-7 pubmed
    ..Renin protein levels measured in the kidney medulla, to avoid contribution from juxtaglomerular apparatus cells, were higher in ANG II-infused rats [1.64 +/- 0.3 vs. 1.00 +/- 0...
  50. Thorup C, Erik A, Persson G. Macula densa derived nitric oxide in regulation of glomerular capillary pressure. Kidney Int. 1996;49:430-6 pubmed
    ..iNOS, widely expressed in the kidney, does not seem to play any important role in regulation of PGC. ..
  51. Toma I, Kang J, Sipos A, Vargas S, Bansal E, Hanner F, et al. Succinate receptor GPR91 provides a direct link between high glucose levels and renin release in murine and rabbit kidney. J Clin Invest. 2008;118:2526-34 pubmed publisher
  52. Bovetti S, Bonzano S, Garzotto D, Giannelli S, Iannielli A, Armentano M, et al. COUP-TFI controls activity-dependent tyrosine hydroxylase expression in adult dopaminergic olfactory bulb interneurons. Development. 2013;140:4850-9 pubmed publisher
    ..Our study reveals a previously unknown role for COUP-TFI in the adult brain as a key regulator in the control of sensory-dependent plasticity in olfactory dopaminergic neurons. ..
  53. Lu Y, Wei J, Stec D, Roman R, Ge Y, Cheng L, et al. Macula Densa Nitric Oxide Synthase 1? Protects against Salt-Sensitive Hypertension. J Am Soc Nephrol. 2016;27:2346-56 pubmed publisher
    ..Furthermore, macula densa NO production was similar in the isolated perfused juxtaglomerular apparatus of wild-type (WT) and nitric oxide synthase 1?-knockout (NOS1?KO) mice...