Eisenhauer T, Talartschik J, Scheler F
Klin Wochenschr. 1986;64 Suppl 6:68-72.
There are no reliable parameters for the detection of fluid overload in anuric patients. In 70 patients on regular haemodialysis (HD) or haemofiltration (HF) treatment, plasma ANP IR concentrations were determined by radioimmunoassay and compared to 43 controls with normal renal function. ANP IR levels were markedly elevated immediately before HD or HF (m 82 fmol/ml) compared to ANP IR plasma concentrations after HD or HF (m 42 fmol/ml) and to ANP IR levels of healthy controls (m 19 fmol/ml). ANP IR was detected in haemofiltrates and found to be eliminated by HF. During isovolemic HF, ANP IR levels remained constant suggesting that ANP synthesis is much higher than elimination by HF and that the decrease in circulating volume at the end of HF or HD is the main stimulus for a lower secretion rate of ANP. Elevated ANP IR levels at the end of HD/HF were found to be associated with fluid overload even without clinical or radiographic symptoms. Consistent weight reduction was followed by a decrease of ANP IR levels.
对于无尿患者，目前尚无检测液体超负荷的可靠参数。对70例接受常规血液透析（HD）或血液滤过（HF）治疗的患者，采用放射免疫分析法测定其血浆心钠素免疫反应（ANP IR）浓度，并与43例肾功能正常的对照者进行比较。与血液透析或血液滤过治疗后（平均42 fmol/ml）及健康对照者（平均19 fmol/ml）的血浆ANP IR浓度相比，血液透析或血液滤过治疗前ANP IR水平显著升高（平均82 fmol/ml）。在血液滤出液中检测到ANP IR，且发现其可被血液滤过清除。在等容血液滤过期间，ANP IR水平保持恒定，这表明ANP的合成远高于血液滤过的清除量，且血液滤过或血液透析结束时循环血容量的减少是ANP分泌率降低的主要刺激因素。即使没有临床或影像学症状，也发现血液透析/血液滤过结束时升高的ANP IR水平与液体超负荷有关。持续减重后ANP IR水平下降。
