In the normal physiological state in humans, the distribution, composition, and volume of body fluids are held within relatively narrow limits, despite wide variations in the intake of water and Na+. Such homeostasis or stability of the internal environment requires a multifactoral collaboration of the hormones and other physiological processes that affect electrolyte and water metabolism. Thus, as has been reviewed in the preceding sections of this chapter, a diverse array of hormones (aldosterone, angiotensin II, renin, ANP, NO, endothelin, vasopressin, prostaglandins, and ki-nins) and signal transduction systems, each responding to different stimuli, is integrated to provide the kidney and cardiovascular system with coherent messages to effect the collective regulation of blood pres-

TABLE 15-9 Biological Actions of Nitric Oxide



Cardiovascular Smooth muscle

Platelets Nervous Peripheral


Host defense Macrophages"! Leukocytes j-Monocytes J

Initiate vasorelaxation; control of regional blood flow and blood pressure

Limitation of aggregation and adhesion

Neurotransmission (penile erection, gastric emptying)

Neurotransmission; long-term potentiation (appetite control, nociception)

Defense against bacteria, fungi, protozoans, parasites, and viruses

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