Targeting the renin–angiotensin–aldosterone system to prevent hypertension and kidney disease of developmental origins

Chien Ning Hsu, You Lin Tain*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

52 Scopus citations

Abstract

The renin-angiotensin-aldosterone system (RAAS) is implicated in hypertension and kidney disease. The developing kidney can be programmed by various early-life insults by so-called renal programming, resulting in hypertension and kidney disease in adulthood. This theory is known as developmental origins of health and disease (DOHaD). Conversely, early RAAS-based interventions could reverse program processes to prevent a disease from occurring by so-called reprogramming. In the current review, we mainly summarize (1) the current knowledge on the RAAS implicated in renal programming; (2) current evidence supporting the connections between the aberrant RAAS and other mechanisms behind renal programming, such as oxidative stress, nitric oxide deficiency, epigenetic regulation, and gut microbiota dysbiosis; and (3) an overview of how RAAS-based reprogramming interventions may prevent hypertension and kidney disease of developmental origins. To accelerate the transition of RAAS-based interventions for prevention of hypertension and kidney disease, an extended comprehension of the RAAS implicated in renal programming is needed, as well as a greater focus on further clinical translation.

Original languageEnglish
Article number2298
Pages (from-to)1-23
Number of pages23
JournalInternational Journal of Molecular Sciences
Volume22
Issue number5
DOIs
StatePublished - 01 03 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Angiotensin-converting enzyme
  • Chronic kidney disease
  • Developmental origins of health and disease (DOHaD)
  • Hypertension
  • Nephron
  • Nitric oxide
  • Oxidative stress
  • Renin-angiotensin-aldosterone system

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