BNP as a Major Player in the Heart-Kidney Connection

Int J Mol Sci. 2019 Jul 22;20(14):3581. doi: 10.3390/ijms20143581.

Abstract

Brain natriuretic peptide (BNP) is an important biomarker for patients with heart failure, hypertension and cardiac hypertrophy. Although it is known that BNP levels are relatively higher in patients with chronic kidney disease and no heart disease, the mechanism remains unknown. Here, we review the functions and the roles of BNP in the heart-kidney interaction. In addition, we discuss the relevant molecular mechanisms that suggest BNP is protective against chronic kidney diseases and heart failure, especially in terms of the counterparts of the renin-angiotensin-aldosterone system (RAAS). The renal medulla has been reported to express depressor substances. The extract of the papillary tips from kidneys may induce the expression and secretion of BNP from cardiomyocytes. A better understanding of these processes will help accelerate pharmacological treatments for heart-kidney disease.

Keywords: cardiorenal syndrome; kidney; medulla; natriuretic peptide; renin-angiotensin-aldosterone system; vasodilator; vasopressor.

Publication types

  • Review

MeSH terms

  • Angiotensin Receptor Antagonists / pharmacology
  • Angiotensin Receptor Antagonists / therapeutic use
  • Animals
  • Disease Susceptibility
  • Gene Expression Regulation / drug effects
  • Heart / physiology*
  • Humans
  • Kidney / physiology*
  • Myocytes, Cardiac / drug effects
  • Myocytes, Cardiac / metabolism
  • Natriuretic Peptide, Brain / genetics
  • Natriuretic Peptide, Brain / metabolism*
  • Neprilysin / antagonists & inhibitors
  • Renin-Angiotensin System / drug effects
  • Signal Transduction*
  • Vasoconstrictor Agents / pharmacology
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Angiotensin Receptor Antagonists
  • Vasoconstrictor Agents
  • Natriuretic Peptide, Brain
  • Neprilysin