Hemodynamic and atrial natriuretic peptide responses to fluid removal and reinfusion in hemodialysis patients.
The authors have studied the sequential changes in hemodynamic responses and Atrial Natriuretic Peptide (ANP) levels following bicarbonate hemodialysis with fluid removal followed by an infusion of saline and then ultrafiltration of the added fluid. Cardiac output, stroke volume, and thoracic fluid index (TFI) were measured by transthoracic impedence cardiography. Left cardiac work index (LCWI) was derived using these hemodynamic and mean arterial pressure (MAP) measurements. MAP was lower following dialysis when compared to pure ultrafiltration of a similar fluid loss. LCWI decreased during both dialysis and ultrafiltration. TFI, which is inversely related to intrathoracic fluid, increased following dialysis and ultrafiltration. ANP levels fell following fluid removal but remained elevated above normal control levels. The authors conclude that ANP levels are related to fluid not cardiac status in dialysis patients and that impedence cardiography is of value in determining hemodynamic and fluid changes during dialysis.
Petersen
J
J
Division of Nephrology, Stanford University, California.
Li
C C
CC
Bishop-Abney
N
N
Seniw
C M
CM
D009320:Atrial Natriuretic Factor / Q000097:blood*; D001794:Blood Pressure; D002302:Cardiac Output; D002307:Cardiography, Impedance; D006439:Hemodynamics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014462:Ultrafiltration
D009320:Atrial Natriuretic Factor