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In this issue of Cardiovascular Drugs and Therapy, Dontas and colleagues have presented a comprehensive review of nesiritide’s effects on renal function and mortality in heart failure patients [1]. There is much to be learned from the rise and fall of nesiritide—reflecting as much about the impact of positive and negative publicity on practice behavior as it does about science. Yet, after all the controversy is stripped away, there is little mystery regarding nesiritide’s effects; the clinical findings match the expected physiology precisely.

Nesiritide, Heart Failure, and Renal Dysfunction: Irrational Exuberance or Throwing the Baby out with the Bathwater