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Published Online
on October 19, 2009

Hypertension. 2009
Published online before print October 19, 2009, doi: 10.1161/HYPERTENSIONAHA.109.131995
A more recent version of this article appeared on December 1, 2009
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Submitted on March 3, 2009
Revised on March 21, 2009

Reinforcing Feedback Loop of Renal Cyclic Guanosine 3'5'-Monophosphate and Interstitial Hydrostatic Pressure in Pressure-Natriuresis

David C. Lieb*; Brandon A. Kemp; Nancy L. Howell; John J. Gildea; and Robert M. Carey

From the Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, Va.

* To whom correspondence should be addressed. E-mail: liebdc{at}evms.edu.

Abstract—This study addresses the hypothesis that renal interstitial (RI) cGMP, a modulator of pressure-natriuresis, exerts its effect through a relationship with renal interstitial hydrostatic pressure (RIHP). Increasing renal perfusion pressure in Sprague-Dawley rats led to increases in RIHP (5.2±0.6 to 10.9±1.6 mm Hg; P<0.01), urine sodium excretion (0.062±0.009 to 0.420±0.068 μmol/min per gram; P<0.01), and RI cGMP (3.5±0.8 to 9.5±1.7 fmol/min; P<0.01), and these effects were blocked by partial renal decapsulation. Infusion of cGMP into the RI compartment of decapsulated animals restored natriuresis (0.067±0.010 to 0.310±0.061 μmol/min per gram; P<0.01). These changes were independent of changes in glomerular filtration rate . Artificially increasing RIHP in normotensive animals increased RI cGMP (4.1±0.6 to 6.9±0.7 fmol/min; P<0.01) and urine sodium excretion (0.071±0.013 to 0.179±0.039 μmol/min per gram; P<0.05). Coinfusion of organic anion transport-inhibitor probenecid, or soluble guanylyl cyclase inhibitor 1-H(1,2,4) oxadiazolo-(4,2)quinoxalin-1-one, abolished these effects. Infusion of cGMP into the RI compartment of normotensive animals increased RIHP (6.7±0.4 to 10.3±0.9 mm Hg; P<0.001). Exogenous RI cGMP delivery did not affect total, cortical, or medullary renal blood flow. These studies suggest that extracellular RI cGMP is required for the natriuresis observed after increases in renal perfusion pressure and RIHP and that cGMP acts via a tubule mechanism. The results support an intrarenal positive-feedback loop wherein RI cGMP increases RIHP, which, in turn, increases RI cGMP, contributing to the reinforcement of pressure-natriuresis.


Key words: sodium • kidney • cyclic GMP • natriuresis • hydrostatic pressure