The renin–angiotensin–aldosterone-system in sepsis and its clinical modulation with exogenous angiotensin II

Garcia B, Zarbock A, Bellomo R, Legrand M. The role of renin–angiotensin system in sepsis-associated acute kidney injury: mechanisms and therapeutic implications. Curr Opin Crit Care. 2023;29:607–13.

Article  PubMed  Google Scholar 

Asfar P, Meziani F, Hamel J-F, Grelon F, Megarbane B, Anguel N, et al. High versus low blood-pressure target in patients with septic shock. N Engl J Med. 2014;370:1583–93.

Article  CAS  PubMed  Google Scholar 

Lamontagne F, Richards-Belle A, Thomas K, Harrison DA, Sadique MZ, Grieve RD, et al. Effect of reduced exposure to vasopressors on 90-day mortality in older critically ill patients with vasodilatory hypotension: a randomized clinical trial. JAMA. 2020;323:938–49.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Khanna A, English SW, Wang XS, Ham K, Tumlin J, Szerlip H, et al. Angiotensin II for the treatment of vasodilatory shock. N Engl J Med. 2017;377:419–30.

Article  CAS  PubMed  Google Scholar 

Leisman DE, Fernandes TD, Bijol V, Abraham MN, Lehman JR, Taylor MD, et al. Impaired angiotensin II type 1 receptor signaling contributes to sepsis-induced acute kidney injury. Kidney Int. 2021;99:148–60.

Article  CAS  PubMed  Google Scholar 

Leisman DE, Privratsky JR, Lehman JR, Abraham MN, Yaipan OY, Brewer MR, et al. Angiotensin II enhances bacterial clearance via myeloid signaling in a murine sepsis model. Proc Natl Acad Sci U S A. 2022;119:e2211370119.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Yousif NG, Hadi NR, Al-Amran F, Zigam QA. Cardioprotective effects of irbesartan in polymicrobial sepsis: the role of the p38MAPK/NF-κB signaling pathway. Herz. 2018;43:140–5.

Article  CAS  PubMed  Google Scholar 

Laesser M, Oi Y, Ewert S, Fändriks L, Aneman A. The angiotensin II receptor blocker candesartan improves survival and mesenteric perfusion in an acute porcine endotoxin model. Acta Anaesthesiol Scand. 2004;48:198–204.

Article  CAS  PubMed  Google Scholar 

Writing Committee for the REMAP-CAP Investigators, Lawler PR, Derde LPG, van de Veerdonk FL, McVerry BJ, Huang DT, et al. Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19: a randomized clinical trial. JAMA. 2023;329:1183–96.

Article  PubMed Central  Google Scholar 

Gelband CH, Sumners C, Lu D, Raizada MK. Angiotensin receptors and norepinephrine neuromodulation: implications of functional coupling. Regul Pept. 1998;73:141–7.

Article  CAS  PubMed  Google Scholar 

Garcia-Sevilla JA, Dubocovich ML, Langer SZ. Angiotensin II facilitates the potassium-evoked release of 3H-noradrenaline from the rabbit hypothalamus. Eur J Pharmacol. 1979;56:173–6.

Article  CAS  PubMed  Google Scholar 

Gleeson PJ, Crippa IA, Mongkolpun W, Cavicchi FZ, Van Meerhaeghe T, Brimioulle S, et al. Renin as a marker of tissue-perfusion and prognosis in critically ill patients. Crit Care Med. 2019;47:152–8.

Article  CAS  PubMed  Google Scholar 

Busse LW, Schaich CL, Chappell MC, McCurdy MT, Staples EM, Ten Lohuis CC, et al. Association of active renin content with mortality in critically ill patients: a post hoc analysis of the vitamin C, thiamine, and steroids in sepsis (VICTAS) trial. Crit Care Med. 2024;52:441.

Article  CAS  PubMed  Google Scholar 

Bellomo R, Forni LG, Busse LW, McCurdy MT, Ham KR, Boldt DW, et al. Renin and survival in patients given angiotensin ii for catecholamine-resistant vasodilatory shock. A clinical trial. Am J Respir Crit Care Med. 2020;202:1253–61.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Jeyaraju M, McCurdy MT, Levine AR, Devarajan P, Mazzeffi MA, Mullins KE, et al. Renin kinetics are superior to lactate kinetics for predicting in-hospital mortality in hypotensive critically ill patients. Crit Care Med. 2022;50:50–60.

Article  CAS  PubMed  Google Scholar 

Flannery AH, Ortiz-Soriano V, Li X, Gianella FG, Toto RD, Moe OW, et al. Serum renin and major adverse kidney events in critically ill patients: a multicenter prospective study. Crit Care. 2021;25:294.

Article  PubMed  PubMed Central  Google Scholar 

Pode-Shakked N, Ceschia G, Rose JE, Goldstein SL, Stanski NL, Genomics of Pediatric Septic Shock Investigators. Increasing angiotensin-converting enzyme concentrations and absent angiotensin-converting enzyme activity are associated with adverse kidney outcomes in pediatric septic shock. Crit Care. 2023;27:230.

Article  PubMed  PubMed Central  Google Scholar 

Stanski NL, Pode Shakked N, Zhang B, Cvijanovich NZ, Fitzgerald JC, Jain PN, et al. Serum renin and prorenin concentrations predict severe persistent acute kidney injury and mortality in pediatric septic shock. Pediatr Nephrol. 2023;38:3099–108.

Article  PubMed  PubMed Central  Google Scholar 

du Cheyron D, Lesage A, Daubin C, Ramakers M, Charbonneau P. Hyperreninemic hypoaldosteronism: a possible etiological factor of septic shock-induced acute renal failure. Intensive Care Med. 2003;29:1703–9.

Article  PubMed  Google Scholar 

Bellomo R, Wunderink RG, Szerlip H, English SW, Busse LW, Deane AM, et al. Angiotensin I and angiotensin II concentrations and their ratio in catecholamine-resistant vasodilatory shock. Crit Care. 2020;24:43.

Article  PubMed  PubMed Central  Google Scholar 

Leisman DE, Handisides DR, Chawla LS, Albertson TE, Busse LW, Boldt DW, et al. Angiotensin II treatment is associated with improved oxygenation in ARDS patients with refractory vasodilatory shock. Ann Intensive Care. 2023;13:128.

Article  CAS  PubMed  PubMed Central  Google Scholar 

May CN, Ishikawa K, Wan L, Williams J, Wellard RM, Pell GS, et al. Renal bioenergetics during early gram-negative mammalian sepsis and angiotensin II infusion. Intensive Care Med. 2012;38:886–93.

Article  CAS  PubMed  Google Scholar 

Wan L, Langenberg C, Bellomo R, May CN. Angiotensin II in experimental hyperdynamic sepsis. Crit Care. 2009;13:R190.

Article  PubMed  PubMed Central  Google Scholar 

Lankadeva YR, Kosaka J, Evans RG, Bellomo R, May CN. Urinary oxygenation as a surrogate measure of medullary oxygenation during angiotensin II therapy in septic acute kidney injury. Crit Care Med. 2018;46:e41–8.

Article  PubMed  Google Scholar 

Calzavacca P, Evans RG, Bailey M, Bellomo R, May CN. Variable responses of regional renal oxygenation and perfusion to vasoactive agents in awake sheep. Am J Physiol Regul Integr Comp Physiol. 2015;309:R1226-1233.

Article  CAS  PubMed  Google Scholar 

Orfanos SE, Armaganidis A, Glynos C, Psevdi E, Kaltsas P, Sarafidou P, et al. Pulmonary capillary endothelium-bound angiotensin-converting enzyme activity in acute lung injury. Circulation. 2000;102:2011–8.

Article  CAS  PubMed  Google Scholar 

Nukiwa T, Matsuoka R, Takagi H, Ishii Y, Arai T, Kira S. Responses of serum and lung angiotensin-converting enzyme activities in the early phase of pulmonary damage induced by oleic acid in dogs. Am Rev Respir Dis. 1982;126:1080–6.

CAS  PubMed  Google Scholar 

Mao X, Krenn K, Tripp T, Tretter V, Reindl-Schwaighofer R, Kraft F, et al. Tidal volume-dependent activation of the renin-angiotensin system in experimental ventilator-induced lung injury. Crit Care Med. 2022;50:e696-706.

Article  CAS  PubMed  Google Scholar 

Imai Y, Kuba K, Rao S, Huan Y, Guo F, Guan B, et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature. 2005;436:112–6.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Idell S, Kueppers F, Lippmann M, Rosen H, Niederman M, Fein A. Angiotensin converting enzyme in bronchoalveolar lavage in ARDS. Chest. 1987;91:52–6.

Article 

Comments (0)

No login
gif