Swainson C P, Craig K C
Department of Medicine, Royal Infirmary, Edinburgh, UK.
Nephrol Dial Transplant. 1991;6(5):336-41. doi: 10.1093/ndt/6.5.336.
Plasma concentrations of human atrial natriuretic peptide (99-126) are elevated in patients with end-stage chronic renal failure and on haemodialysis. Plasma atrial natriuretic peptide (ANP) concentrations change with extracellular fluid volume, suggesting that ANP continues to have a role in chronic renal failure. We have studied the effects of an infusion (5 pmol/kg per min) in subjects with chronic renal failure (CCr) less than 30 ml/min per 1.73 m2). Glomerular filtration rate and effective renal plasma flow increased by 23% (P less than 0.01) and 27% (P less than 0.01) respectively and sodium excretion more than doubled. Systolic and diastolic blood pressures decreased by 14 (SD 1.6) and 6 (SD 0.8) mmHg respectively (P less than 0.001), and plasma renin activity declined (P less than 0.01). Plasma ANP concentrations were elevated compared to normal subjects and reached a peak of 224 (SD 87) pmol/l at the end of the infusion. Plasma half-life was 4.8 (SD 2.7) min. Plasma concentrations are elevated in chronic renal failure and ANP may play a physiological role in controlling extracellular fluid volume and blood pressure.
晚期慢性肾衰竭患者及接受血液透析的患者，其血浆中人类心房利钠肽（99 - 126）浓度升高。血浆心房利钠肽（ANP）浓度随细胞外液量变化，提示ANP在慢性肾衰竭中持续发挥作用。我们研究了对慢性肾衰竭患者（肌酐清除率（CCr）低于30 ml/min per 1.73 m2）输注（5 pmol/kg per min）的效果。肾小球滤过率和有效肾血浆流量分别增加了23%（P < 0.01）和27%（P < 0.01），钠排泄量增加了一倍多。收缩压和舒张压分别下降了14（标准差1.6）和6（标准差0.8）mmHg（P < 0.001），血浆肾素活性下降（P < 0.01）。与正常受试者相比，血浆ANP浓度升高，输注结束时达到峰值224（标准差87）pmol/l。血浆半衰期为4.8（标准差2.7）分钟。慢性肾衰竭患者血浆浓度升高，ANP可能在控制细胞外液量和血压方面发挥生理作用。
