TY - JOUR
T1 - Dual effects of RAS blockade on blood pressure and podocyte function
AU - Reiser, Jochen
AU - Mundel, Peter
N1 - Funding Information:
This work was supported by grants from the KMD Foundation, the American Society for Nephrology, and by National Institutes of Health (NIH) grant DK073495 to JR. PM is supported by NIH grants DA18886, DK57683, DK062472, and George M. O’Brien Kidney Center grant DK064236.
PY - 2007/11
Y1 - 2007/11
N2 - There is no question about the contributory risk of hypertension in morbidity and mortality from cardio-vascular (CV) disease and chronic kidney disease (CKD). Another independent risk factor for CV disease and CKD is proteinuria, which is most commonly caused by dysfunction of the kidney glomerular filter, in particular of the podocyte. Podocytes are highly differentiated pericyte-like cells that are essential to normal kidney function. Moreover, loss of podocytes is a hallmark of diabetic and nondiabetic progressive CKD. Recent data point to an important role for the renin-angiotensin system (RAS) and calcium signaling in the structural and functional integrity of podocytes. Given this scenario, it is desirable to treat hypertension with agents targeting the RAS, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II (Ang II) type 1-receptor blockers (ARB). These agents have proven effects on lowering blood pressure (BP) and can reduce podocyte injury. Here we review the dual effects of RAS blockade on BP and on podocyte function and emphasize BP-dependent and BP-independent effects of this regimen.
AB - There is no question about the contributory risk of hypertension in morbidity and mortality from cardio-vascular (CV) disease and chronic kidney disease (CKD). Another independent risk factor for CV disease and CKD is proteinuria, which is most commonly caused by dysfunction of the kidney glomerular filter, in particular of the podocyte. Podocytes are highly differentiated pericyte-like cells that are essential to normal kidney function. Moreover, loss of podocytes is a hallmark of diabetic and nondiabetic progressive CKD. Recent data point to an important role for the renin-angiotensin system (RAS) and calcium signaling in the structural and functional integrity of podocytes. Given this scenario, it is desirable to treat hypertension with agents targeting the RAS, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II (Ang II) type 1-receptor blockers (ARB). These agents have proven effects on lowering blood pressure (BP) and can reduce podocyte injury. Here we review the dual effects of RAS blockade on BP and on podocyte function and emphasize BP-dependent and BP-independent effects of this regimen.
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U2 - 10.1007/s11906-007-0074-7
DO - 10.1007/s11906-007-0074-7
M3 - Review article
C2 - 18177588
AN - SCOPUS:36849030228
SN - 1522-6417
VL - 9
SP - 403
JO - Current Hypertension Reports
JF - Current Hypertension Reports
IS - 5
ER -