Effect of atrial natriuretic peptide on blood pressure, guanosine 3':5'-cyclic monophosphate release and blood volume in uraemic patients.
1. Eleven patients on chronic maintenance dialysis were investigated before and after intravenous bolus injection of atrial natriuretic peptide (2 micrograms/kg body weight). 2. Mean blood pressure was reduced to the same extent in the uraemic patients as in 11 healthy subjects, with a nadir 3 min after the atrial natriuretic peptide injection at which time mean blood pressure was reduced by 13% (median) in the uraemic patients and 11% in the healthy subjects. 3. Basal plasma atrial natriuretic peptide and guanosine 3':5'-cyclic monophosphate levels were higher in the uraemic patients than in the healthy subjects, but guanosine 3':5'-cyclic monophosphate increased markedly in both groups after atrial natriuretic peptide injection. 4. Using changes in gamma-emission from blood after previous labelling of erythrocytes with 51Cr, and changes in packed cell volume, haemoglobin and erythrocyte count, a reversible shift of fluid from the intravascular phase was demonstrated in the uraemic subjects. The blood volume was maximally reduced by 6% (median) of initial blood volume at 30 min after atrial natriuretic peptide injection. 5. Correlation analyses gave no evidence of a causal relationship between the changes in mean blood pressure and changes in blood volume, angiotensin II, aldosterone or arginine vasopressin after atrial natriuretic peptide injection. 6. It is concluded that a pharmacological dose of atrial natriuretic peptide reduces blood pressure in uraemic patients on maintenance dialysis to the same extent as in healthy subjects. The blood-pressure-reducing effect of atrial natriuretic peptide does not seem to be mediated by its diuretic effect or ability to displace fluid from plasma to the interstitial fluid compartment.
Jespersen
B
B
Department of Medicine C, Aarhus Kommunehospital, Denmark.
Eiskjaer
H
H
Pedersen
E B
EB
D000328:Adult; D000450:Aldosterone / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D001127:Arginine Vasopressin / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D001810:Blood Volume / Q000187:drug effects*; D006152:Cyclic GMP / Q000097:blood*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D014511:Uremia / Q000097:blood / Q000503:physiopathology*
D000804:Angiotensin II; D001127:Arginine Vasopressin; D000450:Aldosterone; D009320:Atrial Natriuretic Factor; D006152:Cyclic GMP