Renin-Angiotensin System Induced Secondary Hypertension: The Alteration of Kidney Function and Structure
Long-term hypertension is known as a major risk factor for cardiovascular and chronic kidney disease (CKD). The Renin-angiotensin system (RAS) plays a key role in hypertension pathogenesis. Angiotensin II (Ang II) enhancement in Ang II-dependent hypertension leads to progressive CKD and kidney fibro...
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Wiley
2021-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2021/5599754 |
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| author | Zahra Pezeshki Mehdi Nematbakhsh |
| author_facet | Zahra Pezeshki Mehdi Nematbakhsh |
| author_sort | Zahra Pezeshki |
| collection | DOAJ |
| description | Long-term hypertension is known as a major risk factor for cardiovascular and chronic kidney disease (CKD). The Renin-angiotensin system (RAS) plays a key role in hypertension pathogenesis. Angiotensin II (Ang II) enhancement in Ang II-dependent hypertension leads to progressive CKD and kidney fibrosis. In the two-kidney one-clip model (2K1C), more renin is synthesized in the principal cells of the collecting duct than juxtaglomerular cells (JGCs). An increase of renal Ang I and Ang II levels and a decrease of renal cortical and medullary Ang 1–7 occur in both kidneys of the 2K1C hypertensive rat model. In addition, the activity of the angiotensin-converting enzyme (ACE) increases, while ACE2’s activity decreases in the medullary region of both kidneys in the 2K1C hypertensive model. Also, the renal prolyl carboxypeptidase (PrCP) expression and its activity reduce in the clipped kidneys. The imbalance in the production of renal ACE, ACE2, and PrCP expression causes the progression of renal injury. Intrarenal angiotensinogen (AGT) expression and urine AGT (uAGT) excretion rates in the unclipped kidney are greater than the clipped kidney in the 2K1C hypertensive rat model. The enhancement of Ang II in the clipped kidney is related to renin secretion, while the elevation of intrarenal Ang II in the unclipped kidney is related to stimulation of AGT mRNA and protein in proximal tubule cells by a direct effect of systemic Ang II level. Ang II-dependent hypertension enhances macrophages and T-cell infiltration into the kidney which increases cytokines, and AGT synthesis in proximal tubules is stimulated via cytokines. Accumulation of inflammatory cells in the kidney aggravates hypertension and renal damage. Moreover, Ang II-dependent hypertension alters renal Ang II type 1 & 2 receptors (AT1R & AT2R) and Mas receptor (MasR) expression, and the renal interstitial fluid bradykinin, nitric oxide, and cGMP response to AT1R, AT2R, or BK B2-receptor antagonists. Based on a variety of sources including PubMed, Google Scholar, Scopus, and Science-Direct, in the current review, we will discuss the role of RAS-induced secondary hypertension on the alteration of renal function. |
| format | Article |
| id | doaj-art-0ae5c9c4e244473ea932f1bfd3e2103c |
| institution | Kabale University |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-0ae5c9c4e244473ea932f1bfd3e2103c2025-08-20T03:54:28ZengWileyInternational Journal of Nephrology2090-214X2090-21582021-01-01202110.1155/2021/55997545599754Renin-Angiotensin System Induced Secondary Hypertension: The Alteration of Kidney Function and StructureZahra Pezeshki0Mehdi Nematbakhsh1Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, IranWater and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, IranLong-term hypertension is known as a major risk factor for cardiovascular and chronic kidney disease (CKD). The Renin-angiotensin system (RAS) plays a key role in hypertension pathogenesis. Angiotensin II (Ang II) enhancement in Ang II-dependent hypertension leads to progressive CKD and kidney fibrosis. In the two-kidney one-clip model (2K1C), more renin is synthesized in the principal cells of the collecting duct than juxtaglomerular cells (JGCs). An increase of renal Ang I and Ang II levels and a decrease of renal cortical and medullary Ang 1–7 occur in both kidneys of the 2K1C hypertensive rat model. In addition, the activity of the angiotensin-converting enzyme (ACE) increases, while ACE2’s activity decreases in the medullary region of both kidneys in the 2K1C hypertensive model. Also, the renal prolyl carboxypeptidase (PrCP) expression and its activity reduce in the clipped kidneys. The imbalance in the production of renal ACE, ACE2, and PrCP expression causes the progression of renal injury. Intrarenal angiotensinogen (AGT) expression and urine AGT (uAGT) excretion rates in the unclipped kidney are greater than the clipped kidney in the 2K1C hypertensive rat model. The enhancement of Ang II in the clipped kidney is related to renin secretion, while the elevation of intrarenal Ang II in the unclipped kidney is related to stimulation of AGT mRNA and protein in proximal tubule cells by a direct effect of systemic Ang II level. Ang II-dependent hypertension enhances macrophages and T-cell infiltration into the kidney which increases cytokines, and AGT synthesis in proximal tubules is stimulated via cytokines. Accumulation of inflammatory cells in the kidney aggravates hypertension and renal damage. Moreover, Ang II-dependent hypertension alters renal Ang II type 1 & 2 receptors (AT1R & AT2R) and Mas receptor (MasR) expression, and the renal interstitial fluid bradykinin, nitric oxide, and cGMP response to AT1R, AT2R, or BK B2-receptor antagonists. Based on a variety of sources including PubMed, Google Scholar, Scopus, and Science-Direct, in the current review, we will discuss the role of RAS-induced secondary hypertension on the alteration of renal function.http://dx.doi.org/10.1155/2021/5599754 |
| spellingShingle | Zahra Pezeshki Mehdi Nematbakhsh Renin-Angiotensin System Induced Secondary Hypertension: The Alteration of Kidney Function and Structure International Journal of Nephrology |
| title | Renin-Angiotensin System Induced Secondary Hypertension: The Alteration of Kidney Function and Structure |
| title_full | Renin-Angiotensin System Induced Secondary Hypertension: The Alteration of Kidney Function and Structure |
| title_fullStr | Renin-Angiotensin System Induced Secondary Hypertension: The Alteration of Kidney Function and Structure |
| title_full_unstemmed | Renin-Angiotensin System Induced Secondary Hypertension: The Alteration of Kidney Function and Structure |
| title_short | Renin-Angiotensin System Induced Secondary Hypertension: The Alteration of Kidney Function and Structure |
| title_sort | renin angiotensin system induced secondary hypertension the alteration of kidney function and structure |
| url | http://dx.doi.org/10.1155/2021/5599754 |
| work_keys_str_mv | AT zahrapezeshki reninangiotensinsysteminducedsecondaryhypertensionthealterationofkidneyfunctionandstructure AT mehdinematbakhsh reninangiotensinsysteminducedsecondaryhypertensionthealterationofkidneyfunctionandstructure |