The syndrome of congestive heart failure is characterized by activatio
n of many neurohormonal systems with vasoconstrictor and vasodilator a
ctions. Data suggest that the stimulus that evokes this response is a
threat to the arterial blood pressure. The long-term consequences of t
his response on the kidney are retention of sodium and water. Strategi
es designed to reverse the effects of these neurohormones on the kidne
y have so far had limited success.