Effects of Vasodepressor vs. Vasopressor Arms of Renin Angiotensin System on Renal Hemodynamic Regulation in Renal Ischemia-Reperfusion Injury; Sex Difference

The exact mechanisms involved in acute renal injury (AKI) due to renal ischemia-reperfusion (IR) are not fully understood, although it has been shown that the renin-angiotensin system (RAS) may play an important role in IR-associated AKI. RAS is considered as one of the most important vasoactive systems of endocrine, paracrine and intracrine, which is important in the physiological regulation of cardiovascular function, blood pressure, fluid and electrolytes balance. This system exerts a set of beneficial or adverse vascular and renal effects. The two main arms of RAS include "ACE, angiotensin II, AT1 receptor" (vasoconstrictor arm) and "ACE2, angiotensin 1-7, AT2 receptor and Mas receptor" (vasodilator arm). IR and its outputs have been reported to be sex-dependent. On the other hand, systemic and local RAS function in the regulation of renal hemodynamics can also be affected by gender. In fact, sex and sex hormones affect sensitivity to angiotensin II and angiotensin 1-7. This review article examines the role of RAS receptors of the new vasopressor arm versus the classic vasopressor arm and their function interference, as well as sex differences and it's influence on renal blood flow in renal IR Injury.