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- Title
The Renin–Angiotensin System in Liver Disease.
- Authors
McGrath, Mary S.; Wentworth, Brian J.
- Abstract
The renin–angiotensin system (RAS) is a complex homeostatic entity with multiorgan systemic and local effects. Traditionally, RAS works in conjunction with the kidney to control effective arterial circulation, systemic vascular resistance, and electrolyte balance. However, chronic hepatic injury and resulting splanchnic dilation may disrupt this delicate balance. The role of RAS in liver disease, however, is even more extensive, modulating hepatic fibrosis and portal hypertension. Recognition of an alternative RAS pathway in the past few decades has changed our understanding of RAS in liver disease, and the concept of opposing vs. "rebalanced" forces is an ongoing focus of research. Whether RAS inhibition is beneficial in patients with chronic liver disease appears to be context-dependent, but further study is needed to optimize clinical management and reduce organ-specific morbidity and mortality. This review presents the current understanding of RAS in liver disease, acknowledges areas of uncertainty, and describes potential areas of future investigation.
- Subjects
RENIN-angiotensin system; LIVER diseases; HEPATIC fibrosis; WATER-electrolyte balance (Physiology); PORTAL hypertension; VENOUS pressure
- Publication
International Journal of Molecular Sciences, 2024, Vol 25, Issue 11, p5807
- ISSN
1661-6596
- Publication type
Article
- DOI
10.3390/ijms25115807