Abstract
Current national guidelines have recommended the use of renin-angiotensin system inhibitors, including angiotensin II type 1 receptor blockers (ARBs), in preference to other antihypertensive agents for treating hypertensive patients with chronic kidney disease. However, the mechanisms underlying the renoprotective effects of ARBs are multiple and complex. Blood pressure reduction by systemic vasodilation with an ARB contributes to its beneficial effects in treating kidney disease. Furthermore, ARB-induced renal vasodilation results in an increase in renal blood flow, leading to improvement of renal ischemia and hypoxia. ARBs are also effective in reducing urinary albumin excretion through a reduction in intraglomerular pressure and the protection of glomerular endothelium and/or podocyte injuries. In addition to blocking angiotensin II-induced renal cell and tissue injuries, ARBs can decrease intrarenal angiotensin II levels by reducing proximal tubular angiotensinogen and production of collecting duct renin, as well as angiotensin II accumulation in the kidney. In this review, we will briefly summarize our current understanding of the pharmacological effects of an ARB in the kidney. We will also discuss the possible mechanisms responsible for the renoprotective effects of ARBs on type 2 diabetic nephropathy.
Keywords: Angiotensin II, kidney, angiotensin II type 1 receptor blocker, renal protection, hypertension, chronic kidney disease.
Current Pharmaceutical Design
Title:Angiotensin II Blockade and Renal Protection
Volume: 19 Issue: 17
Author(s): Hiroyuki Kobori, Hirohito Mori, Tsutomu Masaki and Akira Nishiyama
Affiliation:
Keywords: Angiotensin II, kidney, angiotensin II type 1 receptor blocker, renal protection, hypertension, chronic kidney disease.
Abstract: Current national guidelines have recommended the use of renin-angiotensin system inhibitors, including angiotensin II type 1 receptor blockers (ARBs), in preference to other antihypertensive agents for treating hypertensive patients with chronic kidney disease. However, the mechanisms underlying the renoprotective effects of ARBs are multiple and complex. Blood pressure reduction by systemic vasodilation with an ARB contributes to its beneficial effects in treating kidney disease. Furthermore, ARB-induced renal vasodilation results in an increase in renal blood flow, leading to improvement of renal ischemia and hypoxia. ARBs are also effective in reducing urinary albumin excretion through a reduction in intraglomerular pressure and the protection of glomerular endothelium and/or podocyte injuries. In addition to blocking angiotensin II-induced renal cell and tissue injuries, ARBs can decrease intrarenal angiotensin II levels by reducing proximal tubular angiotensinogen and production of collecting duct renin, as well as angiotensin II accumulation in the kidney. In this review, we will briefly summarize our current understanding of the pharmacological effects of an ARB in the kidney. We will also discuss the possible mechanisms responsible for the renoprotective effects of ARBs on type 2 diabetic nephropathy.
Export Options
About this article
Cite this article as:
Kobori Hiroyuki, Mori Hirohito, Masaki Tsutomu and Nishiyama Akira, Angiotensin II Blockade and Renal Protection, Current Pharmaceutical Design 2013; 19 (17) . https://dx.doi.org/10.2174/1381612811319170009
DOI https://dx.doi.org/10.2174/1381612811319170009 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Calixarene: A Versatile Material for Drug Design and Applications
Current Pharmaceutical Design Editorial [Hot Topic: Recent Perspectives on Nanoneuroprotection & Nanoneurotoxicity (Guest Editors: Hari Shanker Sharma and Aruna Sharma)]
CNS & Neurological Disorders - Drug Targets Gonadal Hormones in Adolescent Females with β-Thalassemia in Relation to Iron Load
Endocrine, Metabolic & Immune Disorders - Drug Targets Clinical Update: Treatment of Glioblastoma Multiforme with Radiolabeled Antibodies that Target Tumor Necrosis
Current Cancer Therapy Reviews Omega-3 Polyunsaturated Fatty Acids: Their Potential Role in Blood Pressure Prevention and Management
Current Vascular Pharmacology The Adult Patient with Eisenmenger Syndrome: A Medical Update After Dana Point Part I: Epidemiology, Clinical Aspects and Diagnostic Options
Current Cardiology Reviews Headache, Outpatient Management and Referral to Specialty Clinics, Clinical Audit
New Emirates Medical Journal ATP Binding Cassette Transporter A1 (ABCA1) Associated Proteins:Potential Drug Targets in the Metabolic Syndrome and Atherosclerotic Disease?
Current Pharmaceutical Biotechnology Blood Pressure Variability and Mortality in end Stage Renal Disease
Current Hypertension Reviews From Test Tube to Clinical Trial; Promising Herbs with NF-κB and COX- 2 Activity
Current Immunology Reviews (Discontinued) Editorial [Hot Topic:Role of Food and Nutritional Factors in Metabolic Syndrome X,Cancer and Cardiovascular Diseases (Guest Editor: Undurti N. Das)]
Current Nutrition & Food Science The Need for Diagnostic Criteria in Systemic Vasculitis
Current Immunology Reviews (Discontinued) MicroRNAs as Early Biomarkers in Obesity and Related Metabolic and Cardiovascular Diseases
Current Pharmaceutical Design Nanoparticulated Nitric Oxide Donors and their Biomedical Applications
Mini-Reviews in Medicinal Chemistry Improved Sensory Blockade by Clonidine Added to Axillary Block Solution. Resulting Plasma Clonidine Concentration
Letters in Drug Design & Discovery Clinical Implications of Non-Invasive Measurement of Central Aortic Blood Pressure
Current Vascular Pharmacology Non-uremic Calciphylaxis: A Rare and Late Adverse Reaction of Warfarin
Current Drug Safety Statins in Aortic Disease
Current Pharmaceutical Design Primary and Secondary Insomnia: Prevalence, Causes and Current Therapeutics
Current Medicinal Chemistry - Central Nervous System Agents HIV-1 Infection in Subjects Older than 70: A Multicenter Cross-Sectional Assessment in Catalonia, Spain
Current HIV Research