Renalase is a renal tubule–secreted especially in the proximal tubule, flavin adenine dinucleotide–dependent amine oxidase that degrades catecholamines including epinephrine, norepinephrine and dopamine without effects against other physiologic amines including serotonin, tyramine, or spermidine. Renalase is secreted in blood and its levels are regulated by three key factors: renal function, renal perfusion and catecholamine levels, they hold a direct relationship with the glomerular filtration rate and kidney mass.
Renal sympathetic nerve activation may negatively modulate kidney and plasma renalase levels where increased renal sympathetic nerve activity during and after renal IR exacerbates ischemic AKI by increasing plasma catecholamine levels and downregulating kidney/plasma renalase levels.
Renalase decreases cardiac output and BP by regulating plasma catecholamine levels, modulates the severity of renal ischemia and reperfusion injury, and also serves as a novel and sensitive biomarker for the early detection of ischemic AKI. Recombinant renalase therapy may provide a novel therapeutic tool for the prevention and treatment of AKI.