Role of cGMP in natriuresis and pressure-natriuresis

Abstract

Cyclic GMP (cGMP) is synthesized by renal proximal tubule (RPT) cells and is exported from these cells into the renal interstitial (RI) compartment by an organic anion transporter system. We have demonstrated that RI gGMP inhibits renal Na+ reabsorption at the renal tubule. We have further demonstrated that cGMP-induced natriuresis can be blocked by intrarenal pharmacological inhibition of protein kinase G (PKG). In order to demonstrate that RI cGMP is a potent physiological regulator of Na+ excretion, we selectively decreased RI cGMP using an RI infusion of cGMP-specific phosphodiesterase (PDE), which does not cross the cell membrane and is confined to the extracellular space because of its molecular size. cGMP PDE selectively decreased extracellular RI cGMP levels, without influencing cAMP levels, and caused significant antinatriuresis. On the other hand, blockade of cGMP degradation with selective cGMP PDE inhibitor, zaprinast, increased both RI cGMP and sodium excretion, independently of systemic or renal hemodynamic changes. Therefore, extracellular RI cGMP plays an important role in the regulation of renal Na+ excretion.