Franz M, Woloszczuk W, Hörl W H
Division of Nephrology and Dialysis, Department of Internal Medicine, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Transplantation. 2001 Jul 15;72(1):89-94. doi: 10.1097/00007890-200107150-00018.
Successful kidney transplantation normalizes elevated proatrial natriuretic peptide (proANP) plasma concentrations of renal failure patients in the early posttransplant period. We evaluated plasma and urinary proANP fragments in the late posttransplant period.
Immunoreactive proANP(1-30) and proANP(31-67) were determined in 389 renal transplant (Rtx) recipients in the long-term, follow-up period and in 16 healthy controls.
Rtx recipients had significantly higher concentrations of proANP(1-30) and proANP(31-67) in both plasma and urine than healthy controls. Although their graft function was normal, all of these long-term Rtx recipients were taking glucocorticoids, which increase proANP(1-30) and proANP(31-67) in the circulation to the extent found in this investigation. Two-thirds of these recipients were also taking cyclosporine, which also increases atrial peptides. Urinary proANP(31-67) was significantly higher than urinary proANP(1-30); 5.5-fold in Rtx patients and 2-fold in controls. Deterioration of renal graft function was associated with a rise of plasma proANP(1-30) from 0.98+/-0.66 to 6.28+/-3.55 nmol/l (P<0.0001) and plasma proANP(31-67) from 1.81+/-1.04 to 7.89+/-3.76 nmol/l (P<0.0001). Urinary excretion of proANP(1-30) increased from 0.27+/-0.34 to 5.96+/-5.07 nmol/24 hr (P<0.0001) and proANP(31-67) from 1.45+/-0.85 to 12.23+/-5.12 nmol/24 hr (P<0.0001). Also proteinuria enhanced plasma and urinary proANP fragments.
ProANP(1-30) and proANP(31-67) of Rtx recipients are affected by immunosuppression, hypertension, renal failure, and proteinuria. One would have expected proANP(1-30) and proANP(31-67) not to normalize because of the glucocorticoids that they were receiving.
成功的肾移植可使肾衰竭患者移植后早期升高的血浆心钠素原（proANP）浓度恢复正常。我们评估了移植后期血浆和尿液中的proANP片段。
对389例肾移植（Rtx）受者进行长期随访，并检测其免疫反应性proANP(1 - 30)和proANP(31 - 67)，同时选取16名健康对照者进行检测。
Rtx受者血浆和尿液中的proANP(1 - 30)和proANP(31 - 67)浓度均显著高于健康对照者。尽管他们的移植肾功能正常，但所有这些长期Rtx受者均服用糖皮质激素，糖皮质激素可使循环中的proANP(1 - 30)和proANP(31 - 67)升高至本研究中所发现的水平。这些受者中有三分之二还服用环孢素，环孢素也会增加心房肽。尿液中的proANP(31 - 67)显著高于proANP(1 - 30)；Rtx患者中高出5.5倍，对照者中高出2倍。移植肾功能恶化与血浆proANP(1 - 30)从0.98±0.66 nmol/l升至6.28±3.55 nmol/l（P<0.0001）以及血浆proANP(31 - 67)从1.81±1.04 nmol/l升至7.89±3.76 nmol/l（P<0.0001）相关。尿液中proANP(1 - 30)的排泄量从0.27±0.34 nmol/24小时增至5.96±5.07 nmol/24小时（P<0.0001），proANP(31 - 67)从1.45±0.85 nmol/24小时增至12.23±5.12 nmol/24小时（P<0.0oo1）。蛋白尿也会增加血浆和尿液中的proANP片段。
Rtx受者的proANP(1 - 30)和proANP(31 - 67)受免疫抑制、高血压、肾衰竭和蛋白尿的影响。由于他们正在服用糖皮质激素，人们原本预计proANP(1 - 30)和proANP(31 - 67)不会恢复正常。
