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From the Renal Division, Department of Medicine, Brigham and Women's Hospital, and the Harvard Center for the Study of Kidney Diseases, Harvard Medical School, Boston, Mass.
Correspondence to Harald S. Mackenzie, MB, MRCP(UK), Renal Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
Abstract Previous studies suggest that elevated plasma atrial natriuretic peptide (ANP) levels participate in regulating renal excretory function in rats with congestive heart failure (CHF). To define the role of natriuretic peptides (NPs) in the regulation of renal function in CHF, the renal responses to HS-142-1 (HS), a potent NP receptor antagonist, were studied in anesthetized rats subjected to coronary ligation that developed left ventricular infarction and CHF or in sham-operated (SO) control rats. Plasma ANP levels averaged >14-fold higher in rats with CHF than in SO rats. In response to HS (20 mg/kg IV bolus), both mean arterial pressure and renal vascular resistance increased in rats with CHF but not in SO rats; glomerular filtration rate (GFR, 1.26±0.04 versus 0.76±0.11 mL/min) and renal plasma flow rate (RPF, 3.52±0.27 versus 2.70±0.32 mL/min) were significantly reduced in rats with CHF; and in SO rats, GFR (1.26±0.06 versus 1.20±0.07 mL/min) and RPF (3.98±0.21 versus 3.99±0.18 mL/min) were not significantly affected by HS. The sodium excretion rate (0.18±0.04 to 0.06±0.01 µEq/min) and fractional sodium excretion (0.01±0.02% to 0.04±0.01%) also fell markedly after HS administration in rats with CHF, but these parameters were unchanged in SO rats. These data indicate that NPs play a critical role in maintaining renal hemodynamic function and inhibiting tubule sodium reabsorption in rats with CHF, thus opposing sodium retention and preserving sodium balance in this model.
Key Words: congestive heart failure natriuretic peptides renal dysfunction
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