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Urodilatin is a hormone that causes diuresis through increasing renal blood flow. It is secreted in response to increased mean arterial pressure and increased blood volume from the cells of the distal tubule and collecting duct. It is important in oliguric patients (such as those with acute renal failure and chronic renal failure) as it lowers serum creatinine and increases urine output.

Interactions of Urodilatin

Atrial natriuretic peptide (CDD/ANP-99-126)^[1] is a hormone system of clinical importance. Urodilatin (CDD/ ANP-95-126) is a homologue natriuretic peptide that differs from CDD/ANP-99-126 which is excreted into the circulation via exocytosis. The prototype of the natriuretic hormones is cardiodilatin/atrial natriuretic peptide (CDD/ANP).^[2] The endocrine heart is composed of specific myoendocrine cells that synthesize and secrete the natriuretic peptide hormones which exhibit diuretic, and vasorelaxant properties; secretion is the basis for a paracrine system regulating water and sodium reabsorption.^[3] Research efforts since the early 1980s have studied their effects on electrolyte homeostasis.^[4] When administered intravenously, URO induces strong diuresis and natriuresis with tolerable hemodynamic side effects.^[5] Urodilatin is localized in the kidney, differentially processed (involved in the regulation of body fluid volume and water-electrolyte excretion, while circulating), and secreted into the urine.^[5] As a consequence, urodilatin is involved in drug development along with the prohormone CDD/ANP-1-126 ^[2] and cardiodilatin CDD/ANP-99-126.^[3] A message for the preprohormone is transcribed in the heart and kidneys from the gene of NP type A, resulting in a cGMP-dependent signal transduction which induces diuresis and natriuresis,^[6] differentially processed to a peptide of 32 amino acids from the same precursor as renal ANP, may not be identical to the circulating cardiac hormone ANP.^[7] The kidneys produce their own natriuretic 32-residue peptide. Urodilatin renal natriuretic peptide potency equals or exceeds that of Atriopeptin [ANP-(99-126)], the prototype of cardiodilatin.^[8] Atriopeptin is only of trivial importance in the regulation of sodium excretion during normal living conditions.^[9] Urodilatin is little affected by renal enzymes that inactivate atriopeptin, as the kidney elutes with urodilatin rather than with ANP.^[10] The degradation rates of (125I)-urodilatin and [125I]-ANP by pure recombinant NEP (rNEP) were compared. Phosphoramidon, a potent inhibitor of NEP, completely protected both peptides from metabolism by rNEP.^[11] Urodilatin, has a four-residue extension at the N-terminus neutral endopeptidase-24.11 (NEP) plays a physiological role in metabolizing atrial natriuretic peptide, and C-type natriuretic peptide (prohormone) degraded the bioactive peptides at about half the rate though the C-terminal that compete with natriuretic peptides for hydrolysis by neutral endopeptidase.^[12]

References

^ Gagelmann M, Hock D, Forssmann WG. (June 1988). "Urodilatin (CDD/ANP-95-126) is not biologically inactivated by a peptidase from dog kidney cortex membranes in contrast to atrial natriuretic peptide/cardiodilatin (alpha-hANP/CDD-99-126).". FEBS Lett. 20 (223(2)): 249–54. doi:10.1016/0014-5793(88)80436-8. PMID 2968281.
^ ^a ^b Meyer M, Stief CG, Becker AJ, Truss MC, Taher A, Jonas U, Forssmann WG. (June 1988). "The renal paracrine peptide system--possible urologic implications of urodilatin.". World J Urol. 14 (2): 249–54. doi:10.1007/BF00183118. ISSN 0724-4983. PMID 8986039.
^ ^a ^b Forssmann WG, Richter R, Meyer M. (October 1998). "The endocrine heart and natriuretic peptides: histochemistry, cell biology, and functional aspects of the renal urodilatin system.". Histochem Cell Biol 110 (4): 335–57. doi:10.1007/s004180050295. PMID 9792413.
^ Meyer M, Schulz-Knappe P, Kuse ER, Hummel M, Hetzer R, Pichlmayr R, Forssmann WG. (February 1995). "[Urodilatin. Use of a new peptide in intensive care]". Anaesthesist. 44 (2): 81–91. doi:10.1007/s001010050135. PMID 7702187.
^ ^a ^b Kuse ER, Meyer M, Constantin R, Oldhafer K, Schlitt HJ, Schulz-Knappe P, Uberbacher HJ, Pichlmayr R, Forssmann WG. (April 1996). "[Urodilatin (INN: ularitide). A new peptide in the treatment of acute kidney failure following liver transplantation]". Anaesthesist. 45 (4): 351–8. doi:10.1007/s001010050271. PMID 8702053.
^ Meyer M, Richter R, Forssmann WG. (October 1998). "Urodilatin, a natriuretic peptide with clinical implications.". Eur J Med Res. 3 (1–2): 103–110. PMID 9512977.
^ Forssmann W, Meyer M, Forssmann K. (August 2001). "The renal urodilatin system: clinical implications.". Cardiovasc Res. 51 (3): 450–62. doi:10.1016/S0008-6363(01)00331-5. PMID 11476735.
^ Goetz KL. (December 1991). "Renal natriuretic peptide (urodilatin?) and atriopeptin: evolving concepts.". Am J Physiol. 261 (6): 921–32. PMID 1836308.
^ Goetz KL. (December 1993). "Is urodilatin (rather than atriopeptin) the primary natriuretic peptide of the ANP family?". J Cardiovasc Pharmacol. 22 (6): 911–913. doi:10.1097/00005344-199322002-00027. PMID 7508039.
^ Goetz K, Drummer C, Zhu JL, Leadley R, Fiedler F, Gerzer R. (December 1990). "Evidence that urodilatin, rather than ANP, regulates renal sodium excretion.". J Am Soc Nephrol. 1 (6): 867–74. ISSN 1533-3450. PMID 1966524.
^ Abassi ZA, Golomb E, Agbaria R, Roller PP, Tate J, Keiser HR. (September 1994). "Hydrolysis of iodine labelled urodilatin and ANP by recombinant neutral endopeptidase EC. 3.4.24.11.". Br J Pharmacol. 113 (1): 204–208. doi:10.1111/j.1476-5381.1994.tb16194.x. PMC 1510039. PMID 7812611.
^ Kenny AJ, Bourne A, Ingram J. (April 1998). "Hydrolysis of human and pig brain natriuretic peptides, urodilatin, C-type natriuretic peptide and some C-receptor ligands by endopeptidase-24.11.". Biochem J. 1 (291): 83–8. PMC 1132484. PMID 8097089.

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1. 虚血後（虚血性）の急性尿細管壊死において考え得る予防および治療 possible prevention and therapy of postischemic ischemic acute tubular necrosis

English Journal

Early Results of Human Atrial Natriuretic Peptide Infusion in Non-Dialysis Patients with Chronic Kidney Disease Undergoing Isolated Coronary Artery Bypass Grafting: the NU-HIT Trial for CKD-II.

Sezai A, Nakata KI, Iida M, Yoshitake I, Wakui S, Hata H, Shiono M.SourceThe Department of Cardiovascular Surgery, Nihon University School of Medicine.
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia.Ann Thorac Cardiovasc Surg.2013 Apr 11. [Epub ahead of print]
Background: Chronic kidney disease (CKD) is an important risk factor for cardiac surgery. In the most recently reported NU-HIT trial for CKD with CKD patients underwent coronary artery bypass grafting (CABG) as subjects, carperitide was reported to be effective in terms of renal function. In the pre
PMID 23574999

Clinical Features and Outcome in Hospitalized Heart Failure in Japan (From the ATTEND Registry).

Sato N, Kajimoto K, Keida T, Mizuno M, Minami Y, Yumino D, Asai K, Murai K, Muanakata R, Aokage T, Sakata Y, Mizuno K, Takano T; TEND Investigators.SourceInternal Medicine and Cardiology, Nippon Medical School Musashi-Kosugi Hospital.
Circulation journal : official journal of the Japanese Circulation Society.Circ J.2013 Mar 25;77(4):944-51. Epub 2013 Mar 15.
Background: Hospitalized heart failure (HHF) is a critical issue in Japan. To improve its management and outcomes, the clinical features, in-hospital management, and outcomes should be analyzed to improve the guidelines for HHF. Methods and Results: The acute decompensated heart failure syndrome
PMID 23502987

Japanese Journal

Intermittent infusions of carperitide or inotoropes in out-patients with advanced heart failure.

Nishi Kiyoto,Sato Yukihito,Miyamoto Tadashi,Toma Masanao,Taniguchi Ryoji,Fukuhara Rei,Saijo Sayaka,Fujiwara Hisayoshi,Takatsu Yoshiki
Journal of cardiology 59(3), 366-373, 2012-05
… [Methods]: Between May 2005 and July 2009, we treated 11 patients presenting with advanced HF, who received a total of 369 infusions of carperitide, olprinone, dopamine, or dobutamine, once or twice weekly. … [Results]: Carperitide, olprinone, and catecholamines were administered to 8 (73 infusions of 0.030 ± 0.004 μg/kg/min for 3.3 ± 0.8 h), 4 (18 infusions of 0.070 ± 0.017 μg/kg/min for 3.3 ± 0.5 h), and 6 patients (278 infusions of 3.6 ± 1.9 μg/kg/min for 2.8 ± 1.0 h), respectively. …
NAID 120004108329

Multicenter trial of carperitide in patients with renal dysfunction undergoing cardiovascular surgery

HISATOMI Kazuki,EISHI Kiyoyuki
General thoracic and cardiovascular surgery 60(1), 21-30, 2012-01-10
NAID 10030549937

ミルリノンとカルペリチドの低用量併用療法を実施した重症心不全の犬5例

有田申二,有田昇,日笠喜朗
日本獣医師会雑誌 = Journal of the Japan Veterinary Medical Association 64(9), 728-732, 2011-09-20
NAID 10029702284

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「カルペリチド」

Urodilatin
Identifiers
CAS number	115966-23-9 , 118812-69-4 (ularitide)
PubChem	16132416
ChemSpider	17289074, 11209147
UNII	GZ8FA500J0
KEGG	C16000
MeSH	Urodilatin
Jmol-3D images	Image 1
	SMILES CCC(C)C1C(=O)NCC(=O)NC(C(=O)NC(C(=O)NC(C(=O)NCC(=O)NC(C(=O)NCC(=O)NC(CSSCC(C(=O)NC(C(=O)NCC(=O)NCC(=O)NC(C(=O)NC(C(=O)NC(C(=O)NC(C(=O)N1)CCCNC(=N)N)CC(=O)O)CCSC)CCCNC(=N)N)Cc2ccccc2)NC(=O)C(CO)NC(=O)C(CO)NC(=O)C(CCCNC(=N)N)NC(=O)C(CCCNC(=N)N)NC(=O)C(CC(C)C)NC(=O)C(CO)NC(=O)C(CCCNC(=N)N)NC(=O)C3CCCN3C(=O)C(C)NC(=O)C(C(C)O)N)C(=O)NC(CC(=O)N)C(=O)NC(CO)C(=O)NC(Cc4ccccc4)C(=O)NC(CCCNC(=N)N)C(=O)NC(Cc5ccc(cc5)O)C(=O)O)CC(C)C)CO)CCC(=O)N)C ;
	InChI InChI=InChI=1S/C145H234N52O44S3/c1-11-72(6)112-137(238)171-60-106(208)172-73(7)113(214)177-86(40-41-103(146)205)122(223)190-95(63-198)116(217)170-61-108(210)175-88(51-70(2)3)114(215)169-62-109(211)176-100(133(234)187-92(56-104(147)206)127(228)193-97(65-200)130(231)186-91(54-77-27-16-13-17-28-77)126(227)180-82(31-20-45-163-142(153)154)119(220)189-94(139(240)241)55-78-36-38-79(204)39-37-78)68-243-244-69-101(134(235)185-90(53-76-25-14-12-15-26-76)115(216)168-58-105(207)167-59-107(209)174-80(29-18-43-161-140(149)150)117(218)182-87(42-50-242-10)123(224)188-93(57-110(212)213)128(229)181-85(124(225)196-112)34-23-48-166-145(159)160)195-132(233)99(67-202)194-131(232)98(66-201)192-120(221)83(32-21-46-164-143(155)156)178-118(219)81(30-19-44-162-141(151)152)179-125(226)89(52-71(4)5)184-129(230)96(64-199)191-121(222)84(33-22-47-165-144(157)158)183-135(236)102-35-24-49-197(102)138(239)74(8)173-136(237)111(148)75(9)203/h12-17,25-28,36-39,70-75,80-102,111-112,198-204H,11,18-24,29-35,40-69,148H2,1-10H3,(H2,146,205)(H2,147,206)(H,167,207)(H,168,216)(H,169,215)(H,170,217)(H,171,238)(H,172,208)(H,173,237)(H,174,209)(H,175,210)(H,176,211)(H,177,214)(H,178,219)(H,179,226)(H,180,227)(H,181,229)(H,182,218)(H,183,236)(H,184,230)(H,185,235)(H,186,231)(H,187,234)(H,188,224)(H,189,220)(H,190,223)(H,191,222)(H,192,221)(H,193,228)(H,194,232)(H,195,233)(H,196,225)(H,212,213)(H,240,241)(H4,149,150,161)(H4,151,152,162)(H4,153,154,163)(H4,155,156,164)(H4,157,158,165)(H4,159,160,166)/t72-,73-,74-,75+,80-,81-,82-,83-,84-,85-,86-,87-,88-,89-,90-,91-,92-,93-,94-,95-,96-,97-,98-,99-,100-,101-,102-,111-,112-/m0/s1 ;
Properties
Molecular formula	C145H234N52O44S3
Molar mass	3,505.93 g mol−1
	Except where noted otherwise, data are given for materials in their standard state (at 25 °C (77 °F), 100 kPa)
	Infobox references

　　[★]

英: carperitide
商: ハンプ
関: 心房性ナトリウム利尿ペプチド ANP

[pmid2968281-1] Gagelmann M, Hock D, Forssmann WG. (June 1988). "Urodilatin (CDD/ANP-95-126) is not biologically inactivated by a peptidase from dog kidney cortex membranes in contrast to atrial natriuretic peptide/cardiodilatin (alpha-hANP/CDD-99-126).". FEBS Lett. 20 (223(2)): 249–54. doi:10.1016/0014-5793(88)80436-8. PMID 2968281.

[pmid8986039-2] Meyer M, Stief CG, Becker AJ, Truss MC, Taher A, Jonas U, Forssmann WG. (June 1988). "The renal paracrine peptide system--possible urologic implications of urodilatin.". World J Urol. 14 (2): 249–54. doi:10.1007/BF00183118. ISSN 0724-4983. PMID 8986039.

[pmid9792413-3] Forssmann WG, Richter R, Meyer M. (October 1998). "The endocrine heart and natriuretic peptides: histochemistry, cell biology, and functional aspects of the renal urodilatin system.". Histochem Cell Biol 110 (4): 335–57. doi:10.1007/s004180050295. PMID 9792413.

[pmid7702187-4] Meyer M, Schulz-Knappe P, Kuse ER, Hummel M, Hetzer R, Pichlmayr R, Forssmann WG. (February 1995). "[Urodilatin. Use of a new peptide in intensive care]". Anaesthesist. 44 (2): 81–91. doi:10.1007/s001010050135. PMID 7702187.

[pmid8702053-5] Kuse ER, Meyer M, Constantin R, Oldhafer K, Schlitt HJ, Schulz-Knappe P, Uberbacher HJ, Pichlmayr R, Forssmann WG. (April 1996). "[Urodilatin (INN: ularitide). A new peptide in the treatment of acute kidney failure following liver transplantation]". Anaesthesist. 45 (4): 351–8. doi:10.1007/s001010050271. PMID 8702053.

[pmid9512977-6] Meyer M, Richter R, Forssmann WG. (October 1998). "Urodilatin, a natriuretic peptide with clinical implications.". Eur J Med Res. 3 (1–2): 103–110. PMID 9512977.

[pmid11476735-7] Forssmann W, Meyer M, Forssmann K. (August 2001). "The renal urodilatin system: clinical implications.". Cardiovasc Res. 51 (3): 450–62. doi:10.1016/S0008-6363(01)00331-5. PMID 11476735.

[pmid1836308-8] Goetz KL. (December 1991). "Renal natriuretic peptide (urodilatin?) and atriopeptin: evolving concepts.". Am J Physiol. 261 (6): 921–32. PMID 1836308.

[pmid7508039-9] Goetz KL. (December 1993). "Is urodilatin (rather than atriopeptin) the primary natriuretic peptide of the ANP family?". J Cardiovasc Pharmacol. 22 (6): 911–913. doi:10.1097/00005344-199322002-00027. PMID 7508039.

[pmid1966524-10] Goetz K, Drummer C, Zhu JL, Leadley R, Fiedler F, Gerzer R. (December 1990). "Evidence that urodilatin, rather than ANP, regulates renal sodium excretion.". J Am Soc Nephrol. 1 (6): 867–74. ISSN 1533-3450. PMID 1966524.

[pmid7812611-11] Abassi ZA, Golomb E, Agbaria R, Roller PP, Tate J, Keiser HR. (September 1994). "Hydrolysis of iodine labelled urodilatin and ANP by recombinant neutral endopeptidase EC. 3.4.24.11.". Br J Pharmacol. 113 (1): 204–208. doi:10.1111/j.1476-5381.1994.tb16194.x. PMC 1510039. PMID 7812611.

[pmid8097089-12] Kenny AJ, Bourne A, Ingram J. (April 1998). "Hydrolysis of human and pig brain natriuretic peptides, urodilatin, C-type natriuretic peptide and some C-receptor ligands by endopeptidase-24.11.". Biochem J. 1 (291): 83–8. PMC 1132484. PMID 8097089.

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carperitide