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Review
. 2024 Mar 14;25(6):3298.
doi: 10.3390/ijms25063298.

The Renin-Angiotensin System and Cardiovascular-Kidney-Metabolic Syndrome: Focus on Early-Life Programming

You-Lin Tain  1   2   3 , Chien-Ning Hsu  4   5
Affiliations
Review

The Renin-Angiotensin System and Cardiovascular-Kidney-Metabolic Syndrome: Focus on Early-Life Programming

You-Lin Tain et al. Int J Mol Sci. .

Abstract

The identification of pathological links among metabolic disorders, kidney ailments, and cardiovascular conditions has given rise to the concept of cardiovascular-kidney-metabolic (CKM) syndrome. Emerging prenatal risk factors seem to increase the likelihood of CKM syndrome across an individual's lifespan. The renin-angiotensin system (RAS) plays a crucial role in maternal-fetal health and maintaining homeostasis in cardiovascular, metabolic, and kidney functions. This review consolidates current preclinical evidence detailing how dysregulation of the RAS during pregnancy and lactation leads to CKM characteristics in offspring, elucidating the underlying mechanisms. The multi-organ effects of RAS, influencing fetal programming and triggering CKM traits in offspring, suggest it as a promising reprogramming strategy. Additionally, we present an overview of interventions targeting the RAS to prevent CKM traits. This comprehensive review of the potential role of the RAS in the early-life programming of CKM syndrome aims to expedite the clinical translation process, ultimately enhancing outcomes in cardiovascular-kidney-metabolic health.

Keywords: angiotensin-converting enzyme; cardiovascular disease; chronic kidney disease; developmental origins of health and disease (DOHaD); hypertension; metabolic syndrome; obesity; renin–angiotensin system.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Schema outlining the major organs and components of the renin–angiotensin system.
Figure 2
Figure 2
An overview of the role of the renin–angiotensin system in the developmental programming of adult cardiovascular–kidney–metabolic (CKM) syndrome.
See this image and copyright information in PMC

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