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Potentially represent an unidentified subtype 20, 198 ; . This lower affinity site has been demonstrated, however, to lack stereoselectivity and most likely represents binding to a nonreceptor site 192 ; . With respect to potential novel D2-like subtypes, a fair argument can be made that the D2K binding site described in inner medullary collecting duct is pharmacologically different from the cloned D2 receptor 204, 206, 207 ; . However, insufficient data are available to allow a satisfactory comparison of the D2K binding site with the pharmacological properties of the cloned D3 and D4 DA receptor subtypes 401 ; . Because the current understanding of the localizations and functions of the cloned DA receptor subtypes within the kidney remains fragmentary, the suggestion of the existence of novel receptor subtypes in renal tissue remains highly speculative. XI. DOPAMINERGIC SIGNAL TRANSDUCTION AND HYPERTENSION A. Human Hypertension Several lines of evidence suggest that defects in the renal dopaminergic system may underlie some forms of essential idiopathic ; hypertension. Several groups of patients with high blood pressure have been found to have either high 238, 383 ; or low 10, 208, 209 ; levels of urinary DA excretion, suggesting a heterogeneity of underlying defects 238 ; . Although normal subjects demonstrate a rise in urinary DA excretion after salt loading 335 ; , some hypertensive patients display a paradoxical fall in urinary DA excretion 180 ; . Furthermore, some hypertensive patients have been shown to respond with an exaggerated level of natriuresis and diuresis to the administration of DA 8 ; , fenoldopam 55 ; , or a dopaminergic prodrug gludopa, Ref. 248 ; . Comparison of normotensive subjects with or without a family history of hypertension revealed abnormal levels of DA excretion before the development of high blood pressure, suggesting that the dopaminergic abnormalities are not a secondary effect 208, 384, 409 ; . B. Animal Models of Hypertension Two rat models of genetic hypertension, the Dahl salt-sensitive strain and the spontaneously hypertensive rat SHR ; Okamoto-Aoki strain, display abnormalities in renal DA production or signal transduction 133, 221, 239 ; . After introduction of a high-salt diet, DA production decreased in the Dahl strain 100, 239, 474 ; reminiscent of the response of low renin essential hypertension patients 239 ; . The Dahl strain also shows an impaired natriuretic and diuretic response to volume expansion with isotonic saline 385 ; . Examination of isolated proximal tubules.

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