{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T20:09:29Z","timestamp":1788206969878,"version":"build-2803163510"},"reference-count":31,"publisher":"American Physiological Society","issue":"4","funder":[{"name":"3ive Labs"}],"content-domain":{"domain":["journals.physiology.org"],"crossmark-restriction":true},"short-container-title":["American Journal of Physiology-Regulatory, Integrative and Comparative Physiology"],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:p> Congestion is the primary pathophysiological lesion in most heart failure (HF) hospitalizations. Renal congestion increases renal tubular pressure, reducing glomerular filtration rate (GFR) and diuresis. Because each nephron is a fluid-filled column, renal negative pressure therapy (rNPT) applied to the urinary collecting system should reduce tubular pressure, potentially improving kidney function. We evaluated the renal response to rNPT in congestive HF. Ten anesthetized \u223c80-kg pigs underwent instrumentation with bilateral renal pelvic JuxtaFlow catheters. GFR was determined by iothalamate clearance (mGFR) and renal plasma flow (RPF) by para-aminohippurate clearance. Each animal served as its own control with randomization of left versus right kidney to \u221230 mmHg rNPT or no rNPT. mGFR and RPF were measured simultaneously from the rNPT and no rNPT kidney. Congestive HF was induced via cardiac tamponade maintaining central venous pressure at 20\u201322.5\u2009mmHg throughout the experiment. Before HF induction, rNPT increased natriuresis, diuresis, and mGFR compared with the control kidney ( P &lt; 0.001 for all). Natriuresis, diuresis, and mGFR decreased following HF ( P &lt; 0.001 for all) but were higher in rNPT kidney versus control ( P &lt; 0.001 for all). RPF decreased during HF ( P &lt; 0.001) without significant differences between rNPT treatments. During HF, the rNPT kidney had similar diuresis and natriuresis ( P &gt; 0.5 for both) and higher fractional excretion of sodium ( P = 0.001) compared with the non-rNPT kidney in the no HF period. In conclusion, rNPT resulted in significantly increased diuresis, natriuresis, and mGFR, with or without experimental HF. rNPT improved key renal parameters of the congested cardiorenal phenotype. <\/jats:p>","DOI":"10.1152\/ajpregu.00115.2021","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T12:02:38Z","timestamp":1629288158000},"page":"R588-R594","update-policy":"https:\/\/doi.org\/10.1152\/aps-crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Renal negative pressure treatment as a novel therapy for heart failure-induced renal dysfunction"],"prefix":"10.1152","volume":"321","author":[{"given":"Veena S.","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Maulion","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Asher","sequence":"additional","affiliation":[{"name":"Department of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8800-7298","authenticated-orcid":true,"given":"Juan B.","family":"Ivey-Miranda","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut"},{"name":"Hospital de Cardiologia, Instituto Mexicano del Seguro Social, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary L.","family":"Cox","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, Tennessee"},{"name":"Department of Pharmacy, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julieta","family":"Moreno-Villagomez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut"},{"name":"Facultad de Estudios Superiores Iztacala, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devin","family":"Mahoney","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. 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