Renal Aspects of the Apelinergic System: Therapeutic Potential and Mechanisms

The Apelinergic system (AS) is a crucial endocrine system that plays a vital role in renal physiology and disease. All components of the AS are expressed throughout the kidneys in both humans and rodents. A multitude of studies have consistently shown that the AS exerts a protective effect on the kidneys across a wide spectrum of renal pathologies, encompassing acute kidney injury, chronic kidney disease, diabetic nephropathy, hypertensive kidney injury, cardiorenal syndrome, and renal cell carcinoma. Considering its pivotal role, it shows immense potential as a viable therapeutic target for renal disorders. A deeper mechanistic understanding of the AS will accelerate the rational development of novel therapeutic agents for kidney diseases. In this review, we offer a concise overview of the physiological and pathological roles of the AS in the kidney. Our focus lies on its diuretic effect and its renoprotective action against kidney injury. Enhancing the levels of peripheral Apelin or ELABELA peptides to a certain degree could potentially serve as a promising pharmacological therapeutic strategy for kidney diseases.