Niwa T, Fujishiro T, Uema K, Tsuzuki T, Tominaga Y, Emoto Y, Miyazaki T, Maeda K
Department of Internal Medicine, Nagoya University Branch Hospital, Japan.
Nephron. 1993;64(4):552-9. doi: 10.1159/000187399.
To determine the role of vasoactive peptides such as endothelin (ET), calcitonin gene-related peptide (CGRP) and human atrial natriuretic peptide (hANP) in the regulation of blood pressure in uremic patients, and to determine the effect of various types of dialyzer membranes on hemodialysis (HD)-induced changes in plasma levels of such peptides, plasma ET, CGRP and hANP were measured in HD patients and patients on continuous ambulatory peritoneal dialysis (CAPD). Plasma levels of ET, CGRP, and hANP were significantly higher in HD and CAPD patients than in healthy subjects. There were no significant differences in plasma levels of ET, CGRP, and hANP between hypertensive and normotensive HD patients, and no significant correlation was observed between HD-induced changes in plasma levels and changes in blood pressure. Plasma levels of ET decreased when HD was performed using high-flux membranes, such as polyacrylonitrile (PAN), polymethyl methacrylate (PMMA) and cellulose triacetate (CTA), but did not decrease using a saponified cellulose (SC) membrane. Plasma levels of CGRP decreased in the case of PAN, but increased significantly with PMMA and showed no change with SC and CTA. Plasma levels of hANP decreased in all types of dialyzer membranes due to decreased secretion. These results indicate that the effect of HD on plasma levels of ET and CGRP, but not hANP, depends on the type of dialyzer membrane used.
为了确定血管活性肽如内皮素（ET）、降钙素基因相关肽（CGRP）和人心房利钠肽（hANP）在尿毒症患者血压调节中的作用，并确定不同类型透析器膜对血液透析（HD）引起的此类肽血浆水平变化的影响，我们对HD患者和持续性非卧床腹膜透析（CAPD）患者的血浆ET、CGRP和hANP进行了测量。HD患者和CAPD患者的血浆ET、CGRP和hANP水平显著高于健康受试者。高血压和血压正常的HD患者之间的血浆ET、CGRP和hANP水平无显著差异，且未观察到HD引起的血浆水平变化与血压变化之间存在显著相关性。当使用高通量膜如聚丙烯腈（PAN）、聚甲基丙烯酸甲酯（PMMA）和三醋酸纤维素（CTA）进行HD时，血浆ET水平下降，但使用皂化纤维素（SC）膜时未下降。PAN透析时血浆CGRP水平下降，但PMMA透析时显著升高，而SC和CTA透析时无变化。由于分泌减少，所有类型透析器膜的hANP血浆水平均下降。这些结果表明，HD对ET和CGRP血浆水平的影响（而非对hANP的影响）取决于所用透析器膜的类型。
