title: Acute and long-term changes in plasma levels of atrial natriuretic factor in patients with renal replacement therapy.
abstract: In 14 patients on hemodialysis who received kidney grafts from living related donors, plasma levels of immunoreactive atrial natriuretic factor (Ir-ANF) were determined in a sequence covering the last hemodialysis treatment, the day of transplantation, and a follow-up period of 6-12 months. The geometric mean value before dialysis was 196 pg/ml, the range 32-634. Weight loss during dialysis was 1.5 +/- 1.1 kg (mean +/- SD), but only a nonsignificant reduction in Ir-ANF levels occurred. On the day of transplantation, plasma Ir-ANF levels increased from 143 pg/ml before to 391 post-transplantation (P = 0.02, n = 12), probably in response to deliberate volume expansion. Post-transplant Ir-ANF levels correlated significantly to diuresis during the first 24 h, which ranged from 3.7 to 17.81 (mean 6.6; r = 0.65, P = 0.02). On day 2, mean 24 h diuresis decreased to 3.3 +/- 1.41. Most patients had reached their true dry weight by day 5, but Ir-ANF levels remained high, the geometric mean being 180 pg/ml. During further follow-up and preserved graft function (GFR range 34-88 ml/min per 1.73 m2 body surface area), Ir-ANF levels declined to a geometric mean of 63 pg/ml by 2-6 months and to 36 at 12 months post-transplant. We conclude that plasma Ir-ANF levels are chronically elevated in patients with chronic renal failure but may be further stimulated by acute overhydration. Transplanted kidneys initially respond to the increased levels but adapt within a day. Even with good graft function, normalization of plasma Ir-ANF requires several weeks or months.
authors: Department of Nephrology, Sahlgrenska Hospital, University of Göteborg, Sweden.
authors: G
authors: G
authors: Nyberg
authors: H
authors: H
authors: Herlitz
authors: S
authors: S
authors: Björck
authors: I
authors: I
authors: Karlberg
authors: T
authors: T
authors: Hedner
authors: J
authors: J
authors: Hedner
mesh_terms: D000293:Adolescent; D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D006435:Renal Dialysis; D013997:Time Factors
chemical_list: D009320:Atrial Natriuretic Factor