[Atrium natriuretic peptide in kidney diseases].

The aim of this review is to summarize current knowledge about atrial natriuretic peptide--its role in pathophysiology of renal disease. Presumed role of atrial natriuretic peptide (ANP) in renal pathophysiology is based on the study of blood levels and renal effects of ANP in the presence of different manipulations (variations in dietary sodium intake, posture, water immersion or infusion of synthetic ANP) in patients with different renal diseases. In most of nephrotic patients ANP increases diuresis and natriuresis. However, small to great difference in natriuretic response was found in comparing with healty volunteers. Increased release of ANP in humans with chronic renal insufficiency would be expected as consequence of volume overload, diminished glomerular filtration rate and hypertension. Elevated plasma concentrations of ANP in end-stage renal disease are restored to normal level by successful renal transplantation, indicating that renal function is determinant of plasma ANP concentration. Fluctuations in plasma ANP-level during acute renal failure are related to blood volume changes in these patients.