The renin-angiotensin system in the development of the congenital anomalies of the kidney and urinary tract.

PURPOSE OF REVIEW

Recognition of the dramatically expanded functional repertoire of the renin-angiotensin system now includes a role in morphogenesis of the kidney and urinary tract. On the basis of published data, the article presents formulations of mechanisms through which the system operates.

RECENT FINDINGS

Studies in humans and animals carrying defective angiotensin-related genes have provided unequivocal evidence that the renin-angiotensin system is involved in the normal development of both the kidney and the urinary tract. Angiotensin exerts its function through at least two different types of receptors, AT1 and AT2. AT1 mediates establishment of the ureteral peristaltic machinery, while AT2 mediates the early kidney and urinary tract morphogenesis. Disruption in receptor functions promotes development of congenital anomalies of the kidney and urinary tract.

SUMMARY

Angiotensin is involved in multiple steps of normal development of the kidney and urinary tract through two types of receptors. This takes place in concert with other functionally overlapping genes.