Fig. 8

Proposed model for neural mechanisms in regulating GLP-1 mediated diuresis and natriuresis in HF. GLP-1 activates afferent renal nerve via GLP-1R expressed in the renal pelvis to increase efferent renal nerve activity that regulate diuresis and natriuresis in an inhibitory manner. In HF condition, there is an excessive activation of afferent renal nerve due to an overexpression of GLP-1R in the renal pelvis resulting in an excessive activation of efferent renal nerve thereby suppressing diuresis and natriuresis. Either A-RDN or T-RDN inhibits the activation of neural circuitry utilizing the renal nerves to restore GLP-1 mediated diuresis and natriuresis