Plum J, Ziyaie M, Kemmer F W, Passlick-Deetjen J, Grabensee B
Department of Medicine, University of Düsseldorf.
Adv Perit Dial. 1990;6:211-9.
Patients with end stage renal failure have elevated plasma levels of atrial natriuretic peptide (ANP) which seems to be a sensitive parameter of body fluid status. A prospective study comparing patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) was still missing. Six identical patients (59 +/- 10 yrs, residual diuresis 1.3 +/- 0.61, 1 data expressed as means +/- SEM) were studied in the predialysis phase and under steady state conditions on HD and on CAPD. Plasma levels of ANP, cyclic guanosine monophosphate (cGMP), adrenaline, noradrenaline and dopamine were determined. Blood and dialysate samples were repeatedly taken. Ultrafiltration-volume, dry weight and blood pressure were not different between HD and CAPD. ANP and cGMP reached the highest plasma levels in the predialysis phase with 421 +/- 180 pg/ml and 19.8 +/- 6.4 pmol/ml and decreased after the onset of dialysis treatment. On HD mean ANP levels of 279 +/- 175 pg/ml were not significantly different from those on CAPD (320 +/- 213 pg/ml). However, cGMP concentrations on CAPD (15.7 +/- 5.4 pmol/ml) surpassed the values measured on HD (10.5 +/- 3.4 pmol/ml, p less than 0.05). Plasma noradrenaline was markedly elevated in the predialysis phase (421 +/- 180 pg/ml) and decreased under dialysis treatment. Differences between HD and CAPD were not found. Adrenaline and dopamine concentrations fell within the normal range.
终末期肾衰竭患者血浆心房利钠肽（ANP）水平升高，这似乎是体液状态的一个敏感参数。一项比较血液透析（HD）和持续性非卧床腹膜透析（CAPD）患者的前瞻性研究尚属空白。对6例相同患者（年龄59±10岁，残余尿量1.3±0.61，所有数据均表示为均值±标准误）在透析前阶段以及HD和CAPD稳定状态下进行了研究。测定了血浆ANP、环磷酸鸟苷（cGMP）、肾上腺素、去甲肾上腺素和多巴胺水平。反复采集血液和透析液样本。HD和CAPD之间的超滤量、干体重和血压没有差异。ANP和cGMP在透析前阶段达到最高血浆水平，分别为421±180 pg/ml和19.8±6.4 pmol/ml，透析治疗开始后下降。HD时的平均ANP水平为279±175 pg/ml，与CAPD时（320±213 pg/ml）无显著差异。然而，CAPD时的cGMP浓度（15.7±5.4 pmol/ml）超过了HD时测定的值（10.5±3.4 pmol/ml，p<0.05）。透析前阶段血浆去甲肾上腺素明显升高（421±180 pg/ml），透析治疗时下降。未发现HD和CAPD之间存在差异。肾上腺素和多巴胺浓度在正常范围内。
