Atrial natriuretic peptide, angiotensin II and aldosterone in plasma in chronic glomerulonephritis during basal conditions and during exercise.

Atrial natriuretic peptide (ANP), angiotensin II (AII) and aldosterone (Aldo) in plasma were determined at supine rest in 16 normotensive and 9 hypertensive patients with chronic glomerulonephritis and in 18 control subjects (Study 1). In addition, 12 of the normotensive, 7 of the hypertensive patients and 11 of the control subjects were studied with the same parameters after an exercise test (Study 2). Study 1 showed that supine ANP, AII and Aldo did not differ significantly between the groups. In Study 2, ANP increased after exercise in the normotensive patients (8.4 vs. 11.4 pmol/l (median), p less than 0.05) and control subjects (7.6 vs. 9.3 pmol/l, p less than 0.02) but not in the hypertensives (7.6 vs. 7.9 pmol/l, p greater than 0.10), and after exercise ANP was increased in the normotensive patients compared with the controls (p less than 0.02). After exercise, an enhanced increase of Aldo was found in the hypertensives but not in the normotensive patients compared with the controls, whereas the increase of AII did not differ significantly between the groups. It is concluded that patients with chronic glomerulonephritis and relatively well preserved renal function do not have major abnormalities of ANP at rest or during exercise. In the normotensive patients, however, ANP increased to a higher level than in the controls, but the difference was small and further studies are needed to define the role of ANP in blood pressure regulation of early stage chronic glomerulonephritis.