The balance of angiotensin II and nitric oxide in kidney diseases

PURPOSE OF REVIEW: The imbalances in the activities of various components of the neurohormonal system that maintain renal homeostasis may have important implications in pathophysiology. This review aims to examine the evidence for disparities between angiotensin II and nitric oxide in acute and chronic kidney diseases. RECENT FINDINGS: Low nitric oxide generation and activity characterize chronic kidney disease, whereas decreasing angiotensin activity is known to be beneficial. High oxygen consumption and hypoxia are thought to play important roles in progression of kidney disease, and angiotensin II and nitric oxide appear to influence oxygen consumption in these models. The common etiologic models of acute kidney injury, such as ischemia, nephrotoxic drug administration, radiocontrast exposure and sepsis, also demonstrate significant imbalances in the activities of angiotensin II and nitric oxide. SUMMARY: Disparities between the activities of angiotensin II and nitric oxide are pervasive in a variety of acute and chronic kidney diseases. A better understanding of these interactions and their net effect on renal pathophysiology can lead to therapeutic interventions aimed at preventing or correcting such imbalances.