NPPA and obesity due to melanocortin 4 receptor deficiency: In this regard, obesity-induced DD is associated with multiple abnormalities, including inappropriate activation of tissue Renin–Angiotensin–Aldosterone System (RAAS) [24, 35, 36], as well as, normal or subnormal responses to ANP in the early stages of the disease or enhanced ANP responsiveness at later stages [17].