NPPA and diabetic kidney disease: ANP/NPRA signaling in kidneys counter regulates angiotensin II (ANG II) signaling pathways (29–33), and a number of studies have indicated that ANP-BNP/NPRA/cGMP signaling exerts podocyte protective effects in renal disorders and disease, including aldosterone-induced podocyte injury, immune-mediated renal injury, and diabetic nephropathy (9, 34–36).