The influence of autonomic failure on plasma ANF concentration in uremic patients on chronic hemodialysis.
We compared plasma ANF concentration in 5 diabetic-uremics with combined sympathetic-parasympathetic dysfunction with that in 9 uremic patients without autonomic impairment. Symptomatic dialysis hypotension was a major clinical problem in all diabetic-uremics. In the volume-expanded state, ANF was almost twice as high (p less than 0.025) in diabetic-uremics than in control uremics (152 +/- 29 vs 84 +/- 10 pg/ml) in the face of similar right atrial pressure (14 +/- 3 vs 12 +/- 1 cm H2O). After isolated ultrafiltration, ANF fell significantly in both groups remaining slightly (NS) higher in diabetic-uremics. The slope of the relationship between ANF and right atrial pressure was significantly (p less than 0.01) steeper in diabetic-uremics than in control uremics. The data indicate that autonomic failure amplifies the effect of atrial stretching on plasma ANF in diabetic-uremics on chronic hemodialysis treatment.
Zoccali
C
C
Divisione di Nefrologia, Ospedali Riuniti, Reggio Calabria, Italy.
Mallamaci
F
F
Ciccarelli
M
M
Parlongo
S
S
Salnitro
F
F
D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood*; D001342:Autonomic Nervous System Diseases / Q000097:blood* / Q000150:complications; D001794:Blood Pressure; D003928:Diabetic Nephropathies / Q000097:blood* / Q000150:complications; D003929:Diabetic Neuropathies / Q000097:blood* / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014511:Uremia / Q000097:blood* / Q000150:complications
D009320:Atrial Natriuretic Factor