Cardiac failure, the kidney, renin and atrial peptides

Cardiac failure is characterised by a marked reduction in renal blood flow. However, urea excretion and glomerular filtration rate remain well preserved until the terminal stages. Intrarenal compensatory actions of the renin-angiotensin system probably effect this compensation. Important interrelations have recently been observed between the renin and atrial peptide systems. The latter, which is activated in cardiac failure, tends to emphasise the useful intrarenal effects while minimising the less valuable peripheral actions of the renin system in that condition.