Atrial natriuretic peptide administered as intravenous infusion or bolus injection to patients with liver cirrhosis and ascites.
The effect of a synthetic atrial natriuretic peptide (h-ANP, 25 amino acids, Wy-47.663) on blood pressure, renal electrolyte excretion, plasma catecholamines, and plasma renin activity was studied in nine patients with cirrhosis of the liver and ascites. The peptide was infused intravenously at 24-h intervals for 2 h in groups of four patients each in two different doses (0.015 and 0.075 micrograms/kg/min or 0.06 and 0.3 micrograms/kg/min). A control experiment with the vehicle was performed in all patients. In three patients h-ANP (1 and 2 micrograms/kg i.v.) was administered as an intravenous bolus injection. Consistent falls in blood pressure were observed during h-ANP infusion only with the two higher doses. The two lower infused doses induced a consistent natriuresis; this renal response was abolished when the two larger doses were used. When given as a bolus, h-ANP had a natriuretic effect comparable to that of the two lower doses of infused h-ANP. Plasma catecholamines and plasma renin activity increased during infusion of the two higher doses of h-ANP. It thus appears that in patients with cirrhosis and ascites, the natriuretic effect of infused h-ANP decreases rather than increases when the doses are raised. Bolus administration of h-ANP may be less prone to trigger counterbalancing responses and side-effects.
Petrillo
A
A
Policlinique Médicale Universitaire, C.H.U.V., Lausanne, Switzerland.
Scherrer
U
U
Gonvers
J J
JJ
Nussberger
J
J
Marder
H
H
de Vane
P
P
Waeber
B
B
Hofstetter
J R
JR
Brunner
H R
HR
D000328:Adult; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002395:Catecholamines / Q000097:blood; D004573:Electrolytes / Q000652:urine; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006400:Hematocrit; D006728:Hormones / Q000097:blood; D006801:Humans; D007262:Infusions, Intravenous; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
D002395:Catecholamines; D004573:Electrolytes; D006728:Hormones; D009320:Atrial Natriuretic Factor