Key result
Plasma ahANP levels were elevated in patients with chronic renal failure (16.2 fmol/ml) and those on maintenance hemodialysis (24.3 fmol/ml) compared to healthy subjects (3.8 fmol/ml), relating to the stages of renal damage.
Cross-Sectional (n=37)
Absolute Event Rate: 24.3% vs 3.8%
Plasma ahANP levels are elevated in chronic renal failure in parallel with renal damage and decrease after hemodialysis, suggesting impaired renal metabolism and volume expansion contribute to these elevated levels.
To clarify the molecular nature and dynamics of circulating alpha human atrial natriuretic polypeptide (alpha hANP) in chronic renal disease, the plasma concentrations of alpha hANP were determined by radioimmunoassays using two distinct monoclonal antibodies (MoAbs). One MoAb (10B1) recognized N-terminus of alpha hANP, while the other (C351) recognized the ring structure. The preliminary studies revealed a close correlation (r = 0.97, p less than 0.0001) between plasma alpha hANP measured with 10B1 and C351 MoAbs, supporting the theory that the main circulating form is alpha hANP(1-28). Therefore, the more sensitive radioimmunoassay using MoAb (C351) was used in the present studies. The plasma alpha hANP was 3.8 +/- 1.7 (mean +/- SD) in healthy subjects, 2.7 +/- 1.4 fmol/ml in patients with chronic glomerulonephritis without renal failure, 16.2 +/- 16.8 fmol/ml in patients with chronic renal failure, and 24.3 +/- 10.5 fmol/ml in patients under maintenance hemodialysis. Thus, the elevation of plasma alpha hANP was related to the stages of renal damage. Although the plasma alpha hANP in 18 patients under maintenance hemodialysis declined significantly (p less than 0.01) after hemodialysis, their levels (17.9 +/- 9.0 fmol/ml) after hemodialysis were still higher than those in healthy subjects. On the other hand, a positive correlation (r = 0.65, p less than 0.05) between alpha hANP and creatinine in blood was found only in the group of chronic renal failure before maintenance hemodialysis. These results suggest that an impaired metabolism of alpha hANP in the kidney might play an important role in the elevation of plasma alpha hANP as well as the stimulation of alpha hANP secretion caused by the expansion of extracellular fluid.
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Naomi et al. (1989) conducted a cross-sectional in Chronic renal failure (n=37). Chronic renal failure and hemodialysis vs. Healthy subjects was evaluated on Plasma ahANP concentration. Plasma ahANP levels were elevated in patients with chronic renal failure (16.2 fmol/ml) and those on maintenance hemodialysis (24.3 fmol/ml) compared to healthy subjects (3.8 fmol/ml), relating to the stages of renal damage.
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