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
-
Cardiac Fat as New Diagnostic Tool and Potential Therapeutic Target for Obesity Management and Treatment
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Shear-Wave and Strain Elastography: A Comparative Review on Principles, Basic Techniques and Applications.
Current Medical Imaging Myocardial Revascularization Strategies in Diabetic Patients with Multi-Vessel Disease: CABG vs DES-Based PCI
Current Pharmaceutical Design The Involvement of PPARs in the Causes, Consequences and Mechanisms for Correction of Cardiac Lipotoxicity and Oxidative Stress
Current Molecular Pharmacology Protein and Peptide Biopharmaceuticals: An Overview
Protein & Peptide Letters Study on the Slow-Release Mometasone Furoate Injection of PLGA for the Treatment of Knee Arthritis
Current Drug Delivery A Review of Premature Frailty in HIV-Infected Persons; Another Manifestation of HIV-Related Accelerated Aging
Current Aging Science Why are People with “Poor Lung Function” At Increased Atherothrombotic Risk?A Critical Review with Potential Therapeutic Indications
Current Vascular Pharmacology Approaches for the Development of Drugs for Treatment of Obesity and Metabolic Syndrome
Current Pharmaceutical Design Treatment of Cardiovascular Risk Factors in Women
Current Medicinal Chemistry Nebulizer Therapy in Pulmonology: Review of the Literature
Current Respiratory Medicine Reviews Exploring the use of Estrogen & Progesterone Replacement Therapy in Subarachnoid Hemorrhage
Current Drug Safety The Role of Inflammatory Biomarkers in the Detection and Therapy of Atherosclerotic Disease
Current Vascular Pharmacology The Synthetic Cannabinoids Phenomenon
Current Pharmaceutical Design Inhalation Delivery of Protein Therapeutics
Inflammation & Allergy - Drug Targets (Discontinued) Sodium Intake, Circulating Microvesicles and Cardiovascular Outcomes in Type 2 Diabetes
Current Diabetes Reviews PCSK9 Inhibition - A Novel Mechanism to Treat Lipid Disorders?
Current Pharmaceutical Design Fitness or Fatness - the Debate Continues for the Role of Leptin in Obesity-Associated Heart Dysfunction
Current Diabetes Reviews Effects of Evolocumab on Cardiovascular Events
Current Cardiology Reviews Early Vascular Ageing (EVA): Definitions and Clinical Applicability
Current Hypertension Reviews