Key result
The cortical collecting duct is a major source of intrarenal (pro)renin in hypertension and diabetes, where it can locally activate pro-fibrotic pathways via the (pro)renin receptor.
The cortical collecting duct plays a pivotal role in the local kidney renin-angiotensin system, suggesting renin in this location could be a future therapeutic target or diagnostic marker for nephropathy.
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Hypothesis-generating for collecting duct (pro)renin targeting in hypertension and diabetes; prospective studies needed before clinical adoption.
The renin-angiotensin system is one of the most important hormone systems in the body, and the regulations as well as the role in the juxtaglomerular apparatus are well known. The present review focuses on renin secretion in a recently described localization, the cortical collecting duct. The authors display it in parallel of the copying strategy of an adult and a developing kidney. Furthermore, based on different animal studies it highlights the local role of renin released from the collecting duct. In chronic angiotensin II-infused, 2-kidney, 1-clip hypertensive model as well as in diabetic rats the major source of (pro)renin is indeed the collecting duct. In this localization this hormone can reach both the systemic circulation and the interstitial renin-angiotensin system components including the newly described (pro)renin receptor, by which (pro)renin is able to locally activate pro-fibrotic intracellular signal pathways. Consequently, one can postulate that in the future renin may serve either as a new therapeutic target in nephropathy associated with both hypertension and diabetes or as an early diagnostic marker in chronic diseases leading to nephropathy.
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Csohány et al. (2013) conducted a review in Hypertension and diabetic nephropathy. Cortical collecting duct (pro)renin was evaluated. The cortical collecting duct is a major source of intrarenal (pro)renin in hypertension and diabetes, where it can locally activate pro-fibrotic pathways via the (pro)renin receptor.
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