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Editorial
. 2020 Aug 14;127(5):607-609.
doi: 10.1161/CIRCRESAHA.120.317624. Epub 2020 Aug 13.

New Insights Into the Renin-Angiotensin System in Chronic Kidney Disease

Affiliations
Editorial

New Insights Into the Renin-Angiotensin System in Chronic Kidney Disease

Cheryl L Laffer et al. Circ Res. .
No abstract available

Keywords: Editorials; aging; animals; hypertension; renin.

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Conflict of interest statement

Disclosures

The authors declare no conflict of interest to disclose.

Figures

Figure 1:
Figure 1:. Proposed Model of the differential metabolism of the renin-angiotensin system in normal and chronic kidney disease.
A. In a healthy kidney, most Ang I is converted to Ang-(1-7) by neprilysin (NEP), and to a lesser extent PEP, whereas it conversion to Ang II is quantitatively less important and preferentially by ACE. This results in a tilting of the renin-angiotensin system towards protective effects such as decreasing blood pressure, pro-inflammatory molecule production, and extracellular matrix expansion. B. In CKD patients, less Ang I is converted to Ang 1-7, whereas chymase takes over ACE for generation of excess Ang II. This reversal of the tilt of the RAS promotes oxidative stress, inflammation, and tissue hypertrophy.

Comment on

  • Critical Role of Neprilysin in Kidney Angiotensin Metabolism.
    Kaltenecker CC, Domenig O, Kopecky C, Antlanger M, Poglitsch M, Berlakovich G, Kain R, Stegbauer J, Rahman M, Hellinger R, Gruber C, Grobe N, Fajkovic H, Eskandary F, Böhmig GA, Säemann MD, Kovarik JJ. Kaltenecker CC, et al. Circ Res. 2020 Aug 14;127(5):593-606. doi: 10.1161/CIRCRESAHA.119.316151. Epub 2020 May 18. Circ Res. 2020. PMID: 32418507

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