Rat brain natriuretic peptide-45 (BNP-45) is a new cardiac hormone secreted into the circulation. In order to evaluate the pathophysiologic role of BNP in the nephrotic syndrome, we investigated the plasma levels and effects of BNP in adriamycin (ADR)-induced nephrotic rats. Plasma levels of BNP rose with time and more than doubled in 3 weeks after injection. Plasma levels of BNP correlated significantly with urinary protein excretion (UPrV) and urinary protein/creatinine ratio (UPrV/UcrV). When rat BNP-45 was injected as a bolus, hypotensive, diuretic, and natriuretic effects were completely abolished in nephrotic animals even at a high dose (2.0 nmol/kg), whereas the peptide produced marked UPrV with an increase in UPrV/UcrV. These results indicate that in ADR-induced nephrosis, BNP secretion from the heart is increased. Remarkable resistance to some hemodynamic and renal effects, while prompt proteinuric effects of BNP, may contribute to the sodium and water retention and urinary protein characteristic of this disorder.