Key role of the endocannabinoid system with special emphasis in anandamide on the modulation of cardio-renal homeostasis

The imbalance of cardio-renal homeostasis may lead to the development of multiple cardiovascular and kidney diseases, including systemic and pulmonary hypertension, heart failure, stroke, and acute kidney injury, among others. These pathologies are highly prevalent in worldwide population and have elevated morbimortality rates. Currently, the available therapeutic options are not enough to achieve an adequate control of these diseases. Therefore, the pharmacological manipulation of endocannabinoid system (ECS) arises as an attractive way to improve the prevention and treatment of cardio-renal pathologies. Through vasodilator, antiinflammatory, antioxidant, antifibrotic, antiapoptotic, natriuretic, and diuretic effects of cannabinoids such as anandamide, it is possible to achieve these aims. However, under certain circumstances, pharmacological modulation of ECS may cause opposite effects, which may be deleterious for cardio-renal homeostasis. Hence, this chapter summarizes the most recent findings on endocannabinoid modulation through phyto, endo, and synthetic cannabinoids, which may mediate both harmful and beneficial effects at the cardiovascular and renal level.