[Pathophysiologic and clinical relevance of atrial natriuretic factor in patients with cirrhosis of the liver].
Defects of the ANF system in cirrhosis have not been demonstrated in terms of absolute deficiency of plasma levels or by evidence of major abnormalities of processing in patients with cirrhosis. In the present study, the responsiveness of the ANF system to acute volume stimulation by water immersion and the diuretic and natriuretic effects of ANF infusion were examined. Stimulation of ANF release by 1-h immersion was significantly blunted in ten cirrhotic patients with ascites (increase of plasma ANF by 46 +/- 18%), whereas 11 cirrhotics without ascites showed a 104 +/- 16% increase, similar to the 117 +/- 29% stimulation in 25 healthy controls. Immersion increased urinary volume by 3.6 +/- 0.6/2.0 +/- 0.8/0.7 +/- 0.4 ml/min and urinary sodium excretion by 146 +/- 38/75 +/- 43/43 +/- 19 mumol/min in controls/cirrhotics without/cirrhotics with ascites. Infusion of ANF for 30 min prompted an increase in diuresis and natriuresis in seven cirrhotic patients, which was less marked in patients with ascites, as compared to patients without ascites. Thus, the stimulus response coupling for ANF may be impaired in patients with cirrhosis and ascites.
Gerbes
A L
AL
Medizinische Kliniken I, Klinikum Grosshadern, Universität München.
Arendt
R
R
Xie
Y
Y
Knorr
H J
HJ
Riedel
A
A
Paumgartner
G
G
D001201:Ascites / Q000097:blood / Q000503:physiopathology; D009320:Atrial Natriuretic Factor / Q000097:blood* / Q000494:pharmacology; D004231:Diuresis / Q000187:drug effects; D006801:Humans; D007101:Immersion; D008103:Liver Cirrhosis / Q000097:blood* / Q000503:physiopathology; D009318:Natriuresis / Q000187:drug effects; D012016:Reference Values
D009320:Atrial Natriuretic Factor
Pathophysiologische und klinische Bedeutung des atrialen natriuretischen Faktors bei Patienten mit Leberzirrhose.