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. Author manuscript; available in PMC: 2018 Jul 2.
Published in final edited form as: Handb Exp Pharmacol. 2009;(193):443–470. doi: 10.1007/978-3-540-89615-9_15

Fig. 4.

Fig. 4

a–d Basis for a therapeutic effect of A1AR antagonism in heart failure. The basic effects of adenosine on renal functions are outlined in the legend to Fig. 1. a Heart failure can be associated with increased plasma concentrations of adenosine (ADO) and angiotensin II, and endothelial dysfunction can impair nitric oxide (NO) formation, all of which can enhance the A1AR-mediated lowering of GFR and may, in addition, stimulate proximal reabsorption. b A1AR antagonism induces natriuresis and diuresis by inhibiting proximal reabsorption and preserving or increasing GFR. c A1AR antagonism can enhance sodium transport (TNa) in semihypoxic medullary thick ascending limb (mTAL). This is prevented by coadministration of loop diuretics, and diuresis and natriuresis are potentiated. d A2AR-mediated medullary vasodilation is preserved (adapted from Vallon 2008)