March 1, 1989The International Journal of Artificial Organs

Plasma Concentrations of Atrial Natriuretic Peptide, Arginine Vasopressin and Hormones of the Renin-Angiotensin System in Patients with End-Stage Renal Disease

Q: What is the clinical evidence from this study?

Study design: Observational. Population: End-stage renal disease (n=9). Intervention: Hemodialysis and ultrafiltration vs. Baseline (before procedure) and normal reference population. Primary outcome: Plasma concentrations of ANP, AVP, PRA, and aldosterone.

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Key result

Hemodialysis, but not ultrafiltration, is associated with lower plasma ANP in ESRD.

Why the study?

Do hemodialysis and ultrafiltration alter plasma concentrations of ANP, AVP, PRA, and aldosterone in patients with end-stage renal disease?

Population

9 patients with end-stage renal disease on maintenance hemodialysis

Comparison

3 hours of hemodialysis and 1 hour of… vs Baseline levels before procedures and a normal…

Design

Cohort

Follow-up

3 hours

Authors

AEA.N. EliasUniversity of Malaya NVN. D. VaziriUniversity of California, Irvine Medical Center MPM.R. PandianTamil Nadu Dr. M.G.R. Medical University

Discussion

Member takes

Implication

Suggests volume-mediated ANP changes with hemodialysis in ESRD; leaves open clinical utility pending larger prospective studies.

Key Points

To assess how hemodialysis and isolated ultrafiltration alter plasma levels of atrial natriuretic peptide, arginine vasopressin, plasma renin activity, and aldosterone in patients with end-stage renal disease.
Evaluated 9 patients with end-stage renal disease undergoing maintenance hemodialysis.
Measured plasma concentrations of ANP, AVP, PRA, and aldosterone before and after 3 hours of hemodialysis.
Tested the same 9 patients on a separate occasion before and after 1 hour of isolated ultrafiltration.
Baseline ANP levels were significantly higher than normal reference values and declined significantly after 1 hour and 3 hours of hemodialysis, but showed no significant reduction after 1 hour of ultrafiltration.
Plasma aldosterone levels decreased alongside dialysis-induced reductions in serum potassium, while plasma AVP concentrations did not change significantly after either hemodialysis or ultrafiltration.
Plasma renin activity correlated significantly with systolic blood pressure, but no hormones correlated with heart rate, interdialytic weight gain, or estimated fluid overload.

Study Design

Type

Observational (n=9)

Structured PICO

Do hemodialysis and ultrafiltration alter plasma concentrations of ANP, AVP, PRA, and aldosterone in patients with end-stage renal disease?

Population

9 patients with end-stage renal disease on maintenance hemodialysis.

Exposure

3 hours of hemodialysis and 1 hour of ultrafiltration (on a separate occasion)

Comparator

Baseline levels before procedures and a normal reference population

Outcome

Plasma concentrations of atrial natriuretic peptide (ANP), arginine vasopressin (AVP), plasma renin activity (PRA), and aldosteronesurrogate

Elevated ANP levels in ESRD patients decline following hemodialysis, likely due to the correction of hypervolemia rather than removal by dialysis.

Cite This Study

Elias et al. (1989) conducted an observational in End-stage renal disease (n=9). Hemodialysis and ultrafiltration vs. Baseline (before procedure) and normal reference population was evaluated on Plasma concentrations of ANP, AVP, PRA, and aldosterone. Hemodialysis for 1 and 3 hours, but not 1 hour of ultrafiltration, significantly reduced elevated plasma ANP concentrations in 9 patients with end-stage renal disease.

synapsesocial.com/papers/6aa4d32850d1b974a3f2d58c https://doi.org/10.1177/039139888901200304

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Plasma Concentrations of Atrial Natriuretic Peptide, Arginine Vasopressin and Hormones of the Renin-Angiotensin System in Patients with End-Stage Renal Disease

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Plasma Concentrations of Atrial Natriuretic Peptide, Arginine Vasopressin and Hormones of the Renin-Angiotensin System in Patients with End-Stage Renal Disease

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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