Jovanović O, Mirić-Nastić D, Popović-Rolović M, Antić-Peco A, Kostić M, Kruscić D
University Children's Hospital, Belgrade.
Srp Arh Celok Lek. 1992 Sep-Oct;120(9-10):277-80.
Expansion of extracellular fluid volume,--increasing right atrial pressure,--appears to be a major stimulus for the rise in plasma atrial natriuretic peptide (ANP). End-stage renal disease (ESRD) is associated with significant changes of several hormone systems. Recent studies have shown that plasma ANP concentration is significantly increased in patients with ESRD and that the concentration of the hormone declines following haemodialysis (HD). In patients with ESRD treated by HD "dry weight" for each individual patient is the body weight at which the patients has normal hydration status. The aim of the present study was to determine changes of plasma concentrations of ANP during haemodialysis. We also attempted to check whether the baseline levels of ANP were related to weight loss during dialysis. Eleven children (7 females, 4 males) participated in the study. The patients age related from 8 to 20 years. Plasma concentrations were markedly elevated (p < 0.01) before haemodialysis (251 ae 119) pg/ml) in comparison with control values (61 ae 23 pg/ml), but remained above normal range in all except 4 cases. During HD body weight was reduced in all but one patient. This patient was infused isotonic fluid during HD and did not show weight loss. The four patients who had normal plasma ANP levels at the end of treatment appeared to be in better overall condition than the other patients. In summary, plasma ANP measurements may be of value in establishing the volume status in patients with ESRD. Plasma ANP levels after HD may help to adjust the right dry body weight for each patient.
细胞外液量的增加，即右心房压力的升高，似乎是血浆心房利钠肽（ANP）升高的主要刺激因素。终末期肾病（ESRD）与多个激素系统的显著变化相关。最近的研究表明，ESRD患者的血浆ANP浓度显著升高，且该激素浓度在血液透析（HD）后下降。在接受HD治疗的ESRD患者中，每个患者的“干体重”是指患者处于正常水合状态时的体重。本研究的目的是确定血液透析期间血浆ANP浓度的变化。我们还试图检查ANP的基线水平是否与透析期间的体重减轻有关。11名儿童（7名女性，4名男性）参与了该研究。患者年龄在8至20岁之间。与对照值（61±23 pg/ml）相比，血液透析前血浆浓度显著升高（p<0.01）（251±119 pg/ml），但除4例外，所有患者均高于正常范围。在HD期间，除一名患者外，所有患者的体重均减轻。该患者在HD期间输注了等渗液体，未出现体重减轻。治疗结束时血浆ANP水平正常的4名患者总体状况似乎比其他患者更好。总之，血浆ANP测量可能对确定ESRD患者的容量状态有价值。HD后的血浆ANP水平可能有助于调整每个患者的合适干体重。
