Purpose of review Angiotensin
II is a main regulator of kidney function. Renal actions mediated by the angiotensin
receptor have been well known for many years. In contrast, several details of angiotensin
receptor actions in kidney physiology and pathophysiology were only described very recently. These findings are reviewed in this article.
Regarding the role of the angiotensin
receptor in kidney physiology, a major recent finding was that the AT2
receptor-mediated inhibition of Na+
exchanger-3 and Na+
-ATPase in the renal proximal tubules is caused by internalisation of these transporters, thus reducing reabsorption and increasing natriuresis/diuresis. Regarding renal pathology, several studies demonstrated an attenuation of renal injury caused by diabetes or by obesity with or without high-salt diet through anti-inflammatory, antifibrotic, and antioxidative mechanisms. Generally, AT2
receptor expression seems increased and AT2
receptor-mediated effects stronger in female and obese animals.
The recent findings about the role of the angiotensin
receptor in renal health and disease strongly suggest that pharmacological targeting of this receptor with selective agonists is a promising therapeutic strategy for inducing diuresis/natriuresis (also additive to established diuretics) and for the treatment of diabetic nephropathy
or kidney disease of other pathogenesis.