Elevated plasma C-type natriuretic peptide concentrations in patients with chronic renal failure.
1. C-type natriuretic peptide is a neuropeptide, which is also produced by the vascular endothelial cells. Plasma immunoreactive C-type natriuretic peptide concentrations in patients with various diseases have not yet been studied. 2. Plasma immunoreactive C-type natriuretic peptide concentrations were studied by radioimmunoassay in normal subjects, patients with congestive heart failure, non-dialysed patients with chronic renal failure and haemodialysis patients with chronic renal failure. The C-type natriuretic peptide levels were compared with the levels of atrial natriuretic peptide and brain natriuretic peptide. 3. Plasma immunoreactive C-type natriuretic peptide concentrations were greatly elevated in patients with chronic renal failure [non-dialysed, 13.0 +/- 4.2 pmol/l (mean +/- SEM), n = 9, P < 0.01 compared with normal subjects (4.4 +/- 0.4 pmol/l, n = 26); haemodialysis, 16.1 +/- 2.1 pmol/l, n = 13, P < 0.01], but not in patients with congestive heart failure (New York Heart Association Class II-IV, 3.0 +/- 0.7 pmol/l, n = 11, P > 0.05). Plasma immunoreactive atrial natriuretic peptide and brain natriuretic peptide concentrations were elevated both in patients with congestive heart failure and in haemodialysis patients with chronic renal failure. 4. Reverse-phase high performance liquid chromatography showed that immunoreactive C-type natriuretic peptide in plasma from normal subjects and haemodialysis patients was eluted in the positions of C-type natriuretic peptide-22 and -53. 5. These findings suggest that C-type natriuretic peptide is a non-cardiac circulating hormone and participates in the cardiovascular regulation in a different manner from atrial natriuretic peptide and brain natriuretic peptide.
Second Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
K
K
Totsune
K
K
Takahashi
O
O
Murakami
F
F
Satoh
M
M
Sone
T
T
Mouri
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000378:metabolism*; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006333:Heart Failure / Q000097:blood; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020098:Natriuretic Peptide, C-Type; D011506:Proteins / Q000378:metabolism*; D011863:Radioimmunoassay; D006435:Renal Dialysis
D011506:Proteins; D020098:Natriuretic Peptide, C-Type; D009320:Atrial Natriuretic Factor