The effect of the components of the renin-angiotensinaldosterone system on the development of diabetic nephropathy in type 1 diabetes (review)

Abstract

One of the key roles in the development of diabetic nephropathy belongs to the renin-angiotensin-aldosterone system (RAAS), which is involved in the regulation of hemodynamics, systemic and intrarenal pressure, production of profibrogenic and growth factors, vascular remodeling. At the end of the twentieth century, local (tissue) RAAS elements from renin to aldosterone were found in tissues and target organs (including kidneys). Tissue RAAS plays a leading role in the development of vascular complications of diabetes mellitus (DM): cardiovascular disease, diabetic nephropathy, and retinopathy. It is this fact that explains in many ways the pathogenetic role of RAAS in the defeat of target organs even with normal or low plasma renin activity (ARP). RAAS activation occurs long before the clinical signs of diabetic nephropathy, which makes it possible for earlier prevention and correction of initial changes in the study of its components, as well as reducing disability and the output of patients in chronic kidney disease. Given the tendency to “rejuvenate” diabetes mellitus, the lability of the course of the disease in childhood, the high hormonal activity in this group of patients, and, therefore, the greater the risk of complications, the timely diagnosis of the initial manifestations of DN is of high relevance and relevance.