Atrial natriuretic peptide enhances recovery from ischemia/reperfusion-induced renal injury in rats

Abstract Recovery from ischemic acute kidney injury requires the replacement of damaged tubular cells. This repair process involves epidermal growth factor (EGF) synthesized in medullary the thick ascending limbs (mTAL) of Henle. Atrial natriuretic peptide (ANP), a hormone synthesized by the cardiac atria, increases glomerular filtration rate and renal medullary blood flow. However, the effects of ANP on renal recovery after I/R-induced renal injury remain unclear. We therefore examined whether human ANP enhances recovery from I/R-induced renal injury by reducing damage to EGF-producing kidney cells in a rat model. Male Wistar rats weighing 200–240 g were observed for 48 h after reperfusion following 45-min renal ischemia. Rats were intravenously administered α-human ANP (α-hANP) at 0.2 μg/kg/min beginning immediately after ischemia and continuing for 2 h after reperfusion. Outer medullary blood flow (OMBF), EGF mRNA, serum blood urea nitrogen (BUN) and creatinine levels as indicators of glomerular function were measured, while urinary N -acetyl β- d -glucosaminidase (NAG) was used as a specific indicator of proximal tubular function. OMBF was increased by α-hANP after reperfusion and maintained significantly higher mRNA level of EGF in the kidney 24 h after reperfusion. I/R-induced increases in serum concentrations of BUN and creatinine and urinary concentrations of NAG were also reduced by α-hANP, with improved histopathological changes, including acute tubular necrosis at 24–48 h after reperfusion. This report is the first to demonstrate that α-hANP accelerates recovery following renal ischemic insult by reducing the damage to EGF-producing kidney cells.