Key result
Oxidative stress and reactive oxygen species contribute to renal microcirculatory alterations, playing a key role in the pathophysiology of kidney injury, hypertension, and diabetic nephropathy.
This review highlights how reactive oxygen species-induced renal microcirculatory alterations contribute to the pathophysiology of kidney injury, hypertension, and diabetes.
No immediate change to clinical care; leaves open targeted trials of ROS modulation in kidney disease.
Reactive oxygen species (ROS) are produced by the aerobic metabolism. The imbalance between production of ROS and antioxidant defence in any cell compartment is associated with cell damage and may play an important role in the pathogenesis of renal disease. NADPH oxidase (NOX) family is the major ROS source in the vasculature and modulates renal perfusion. Upregulation of Ang II and adenosine activates NOX via AT1R and A1R in renal microvessels, leading to superoxide production. Oxidative stress in the kidney prompts renal vascular remodelling and increases preglomerular resistance. These are key elements in hypertension, acute and chronic kidney injury, as well as diabetic nephropathy. Renal afferent arterioles (Af), the primary resistance vessel in the kidney, fine tune renal hemodynamics and impact on blood pressure. Vice versa, ROS increase hypertension and diabetes, resulting in upregulation of Af vasoconstriction, enhancement of myogenic responses and change of tubuloglomerular feedback (TGF), which further promotes hypertension and diabetic nephropathy. In the following, we highlight oxidative stress in the function and dysfunction of renal hemodynamics. The renal microcirculatory alterations brought about by ROS importantly contribute to the pathophysiology of kidney injury, hypertension and diabetes.
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Xu et al. (2020) conducted a review in Renal disease, hypertension, and diabetic nephropathy. Reactive oxygen species (ROS) and oxidative stress was evaluated. Oxidative stress and reactive oxygen species contribute to renal microcirculatory alterations, playing a key role in the pathophysiology of kidney injury, hypertension, and diabetic nephropathy.
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