[Is the plasma ANP level an index of volume expansion in dialysis patients?].
Fluid overload is a frequent complication in anuric patients undergoing hemodialysis (HD) or hemofiltration (HF). Elevated ANP plasma concentrations are associated with overhydration or congestive heart failure (CHF). After intensive ultrafiltration in 18 HD patients with high ANP levels at the end of HD, ANP values normalized (28 +/- 4 fmol/ml) in 11 patients (group A), suggesting previous volume overload, whereas ANP remained elevated (126 +/- 31 fmol/ml) in seven patients (group B). Left ventricular ejection fraction by radionuclide ventriculography (LVEF) was significantly (p less than 0.01) lower in group B (41 +/- 7%) as compared to normal values in group A (67 +/- 8%). M-mode echocardiography demonstrated left atrial enlargement (53 +/- 3 mm) and pathologic enddiastolic left ventricular diameters (58 +/- 4 mm) in group B, compared to normal dimensions of left atrial (43 +/- 1 mm) and left ventricular enddiastolic diameters (47 +/- 4 mm) in group A. Persisting high ANP concentrations after intensive ultrafiltration in HD patients indicate CHF and require further diagnostic evaluation.
Talartschik
J
J
Medizinische Universitätsklinik, Göttingen, Abteilung für Nephrologie und Rheumatologie.
Eisenhauer
T
T
Voth
E
E
Sold
G
G
Scheler
F
F
D009320:Atrial Natriuretic Factor / Q000097:blood*; D001810:Blood Volume; D004452:Echocardiography; D005260:Female; D006440:Hemofiltration; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D006435:Renal Dialysis
D009320:Atrial Natriuretic Factor
Ist der Plasma-ANP-Spiegel ein Index für die Volumenexpansion bei Dialysepatienten?