The role of angiotensin II in kidney embryogenesis and kidney abnormalities.

PURPOSE OF REVIEW: The renin-angiotensin system has a major role in the control of blood pressure and homeostasis balance. It also plays a fundamental role in kidney development. Recent insights into how the angiotensin-generating cascade controls developmental processes and homeostasis, and, when defective, causes disease, are discussed. RECENT
FINDINGS: The role of the renin-angiotensin system in kidney development is now widely accepted. New findings discussed in this review include the discovery of the capacity of the kidney to produce its own blood cells simultaneously with in-situ blood vessel formation, a process referred to as hemo-vasculogenesis. In addition, the role of the renin-angiotensin system in hematopoiesis is reviewed. Also discussed are the effects of angiotensin on branching morphogenesis and the development of hypertension in the adult as a result of a reduction in nephron number during nephrogenesis. Furthermore, the relationship between angiotensin and transdifferentiation of epithelial cells into fibroblasts is described.
SUMMARY: The aforementioned advances help to clarify pathological processes such as extramedullary hematopoiesis, post-transplant erythrocytosis, the relationship between nephron number and hypertension, and the role of angiotensin and other growth factors in renal fibrosis. The molecules and pathways whereby angiotensin contributes to the processes mentioned above are beginning to be elucidated.