Angiotensin II and long-term arterial pressure regulation

The overriding dominance of the kidney

John E. Hall, Michael W Brands, Jeffrey R. Henegar

Research output: Contribution to journalReview article

158 Citations (Scopus)

Abstract

The renin-angiotensin system (RAS) is one of the body's most powerful regulators of arterial pressure and body fluid volumes. Although the acute effects of angiotensin II (AngII), the primary active component of the RAS, on arterial pressure are mediated primarily by peripheral vasoconstriction, its chronic BP effects are closely intertwined with volume homeostasis, particularly with intrarenal actions that influence pressure natriuresis. AngII shifts pressure natriuresis toward higher BP primarily by increasing tubular reabsorption rather than decreasing GFR. In fact, activation of the RAS can serve as an important means of preventing decreases in GFR during volume depletion or circulatory depression. However, with prolonged excess AngII formation, particularly in association with hypertension or overperfusion of the kidney, AngII can contribute to glomerular injury and a gradual loss of nephron function through its hemodynamic actions. The multiple effects of AngII to increase tubular reabsorption provide a powerful mechanism to protect against volume depletion and low BP. However, when AngII levels are inappropriately elevated, this necessitates increased arterial pressure to maintain sodium and water balance. Blockade of the RAS has proved to be a powerful therapeutic tool for lowering BP and improving kidney function in disorders such as hypertension, congestive heart failure, and chronic renal disease.

Original languageEnglish (US)
JournalJournal of the American Society of Nephrology
Volume10
Issue number4 SUPPL.
StatePublished - Apr 1 1999
Externally publishedYes

Fingerprint

Angiotensin II
Arterial Pressure
Renin-Angiotensin System
Kidney
Natriuresis
Hypertension
Pressure
Nephrons
Body Fluids
Vasoconstriction
Chronic Renal Insufficiency
Homeostasis
Heart Failure
Hemodynamics
Sodium
Water
Wounds and Injuries

ASJC Scopus subject areas

  • Nephrology

Cite this

Angiotensin II and long-term arterial pressure regulation : The overriding dominance of the kidney. / Hall, John E.; Brands, Michael W; Henegar, Jeffrey R.

In: Journal of the American Society of Nephrology, Vol. 10, No. 4 SUPPL., 01.04.1999.

Research output: Contribution to journalReview article

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