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Systemic and direct renal effects of the two arms of RAS leading to acute kidney injury (AKI): the pressor and harmful arm, mediated by the ACE/Ang II/AT1R axis, and the counteracting depressor and protective arm, mediated by the ACE2/Ang-(1-7)/MasR axis and Ang II/AT2R. In addition to a direct impact on the kidney, systemic RAS imbalance, as occurs in COVID-19 disease, can participate in acute renal dysfunction and injury, which may progress to CKD.
