Effect of alpha-human atrial natriuretic peptide on proteinuria in patients with primary glomerular diseases.
1. The effects of synthetic alpha-human atrial natriuretic peptide (alpha-hANP) on urinary protein excretion were examined in nine healthy subjects and 20 patients with primary glomerular diseases who had proteinuria of 1.0 g or more per day. Synthetic alpha-hANP was intravenously infused into supine subjects at a rate of 8.3 pmol min-1 kg-1 for 40 min. 2. Before alpha-hANP infusion, the plasma concentration of immunoreactive alpha-hANP was significantly higher in the patients with glomerulonephritis than in the normal subjects (44.3 +/- 8.7 vs 19.4 +/- 3.0 pmol/l, mean +/- SEM, P less than 0.01) and it showed a positive correlation with mean arterial pressure (rs = 0.84, P less than 0.001) and a negative correlation with creatinine clearance (rs = -0.50, P less than 0.01). 3. During infusion of alpha-hANP, although the urinary excretion of protein did not change significantly in the normal subjects, it increased from 0.6 +/- 0.2 to 3.0 +/- 0.8 mg min-1 m-2 (P less than 0.001) in the patients with glomerulonephritis. The urinary protein/creatinine ratio did not change significantly in the former (from 0.18 +/- 0.05 to 0.22 +/- 0.06; NS), whereas it rose from 3.25 +/- 0.94 to 7.62 +/- 1.31 (P less than 0.001) in the latter. 4. The urinary excretions of albumin and of alpha 1-, alpha 2-, beta- and gamma-globulins, which were electrophoretically analysed, all increased in eight nephrotic patients during or immediately after infusion of alpha-hANP.(ABSTRACT TRUNCATED AT 250 WORDS)
Ishi
M
M
Second Department of Internal Medicine, University of Tokyo, Japan.
Hirata
Y
Y
Sugimoto
T
T
Matsuoka
H
H
Kimura
K
K
Ishimitsu
T
T
Fukui
K
K
Sugimoto
T
T
Kurosawa
Y
Y
Kiyose
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000378:metabolism; D009320:Atrial Natriuretic Factor / Q000378:metabolism / Q000494:pharmacology*; D003404:Creatinine / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000652:urine*; D006400:Hematocrit; D006801:Humans; D007668:Kidney / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000378:metabolism*; D012083:Renin / Q000097:blood; D012964:Sodium / Q000652:urine; D013997:Time Factors; D010130:p-Aminohippuric Acid / Q000652:urine
D009320:Atrial Natriuretic Factor; D012964:Sodium; D003404:Creatinine; D012083:Renin; D010130:p-Aminohippuric Acid