Peptide
Angiotensin II
Angiotensin II is the endogenous vasoconstrictor peptide now available as a synthetic IV formulation (Giapreza). FDA-approved 2017 for vasodilatory/septic shock refractory to standard vasopressors. A-GRADE evidence from ATHOS-3 (n=321): 70% achieved MAP response vs 23% placebo (P<0.001). Post-hoc analysis: AKI patients on RRT showed 53% vs 30% survival at day 28. SAFETY CONCERN: Increased thromboembolism (13% vs 5%), requires DVT prophylaxis. No mortality benefit in main analysis - approved for hemodynamic response, not survival. PRESCRIPTION ONLY - ICU setting.
- Updated
- How we grade
- 30 studies cited
Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.
- Best evidence
- Grade A
- Conditions studied
- 2
- Outcomes
- 12
- Graded outcomes
- 4134
Evidence by condition
- Strong
- Moderate
- Limited
- Very limited
General
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Renal Recovery in AKI Improvement | Improves (the measure goes up) | 2 studies | ||||
Key findings
- Thromboembolic EventsWorsens (the measure goes down)
- Mean Arterial Pressure ResponseImproves (the measure goes up)
- Vasopressor Dose ReductionImproves (the measure goes down)
Safety notes in the studies
- May reduce catecholamine toxicity.
Studies cited
30 studies from PubMed
- Angiotensin-II and Thromboembolic Events: A Systematic Review
- Angiotensin II Is Involved in MLKL Activation During the Development of Heart Failure Following Myocardial Infarction in Rats.
- The Role of Local Angiotensin II/Angiotensin Type 1-receptor Mechanisms in Adipose Tissue Dysfunction to Promote Pancreatic Cancer.
- Roles of autophagy in angiotensin II-induced cardiomyocyte apoptosis.
- Angiotensin II (Giapreza): A Distinct Mechanism for the Treatment of Vasodilatory Shock
- Vasodilatory shock in the ICU and the role of angiotensin II.
- Angiotensin II for the Treatment of Vasodilatory Shock
- Angiotensin II type 1a receptor-deficient mice develop angiotensin II-induced oxidative stress and DNA damage without blood pressure increase.
- Angiotensin II and skeletal muscle abnormalities.
- Angiotensin (1-7) receptor antagonism equalizes angiotensin II-induced hypertension in male and female spontaneously hypertensive rats.
- Angiotensin II-nitric oxide interaction in the kidney.
- Angiotensin II type 2 receptor decreases ischemia reperfusion induced fluid leak.
- Angiotensin II and renal tubular ion transport.
- Angiotensin II, angiotensin II antagonists and spironolactone and their modulation of cardiac repolarization.
- Angiotensin-II behaves as an endogenous pro-inflammatory molecule.
- Protective effects of angiotensin II interruption: evidence for antiinflammatory actions.
- Cardiac angiotensin II: an intracrine hormone?
- Angiotensin II as a mediator of renal tubular transport.
- Angiotensin II induces phenotype-dependent apoptosis in vascular smooth muscle cells.
- Angiotensin II receptor blockers: review of the binding characteristics.
- Angiotensin II receptors in the kidney.
- Biology and functions of renal receptors for angiotensin II and its active fragments.
- Angiotensin II receptors on colorectal carcinoma cells.
- Regional angiotensin II production in essential hypertension and renal artery stenosis.
- The intrarenal renin-angiotensin system.
- Angiotensin II receptor subtypes in the kidney.
- Angiotensin II is mitogenic in neonatal rat cardiac fibroblasts.
- Angiotensin II and renal hypertension in dog, rat and man: effect of converting enzyme inhibition.
- [Angiotensin II analogue and essential hypertension].
- Angiotensin II in arterial and renal venous plasma and renal lymph in the dog.