title: Plasma atrial natriuretic peptide, body weight and twenty-four-hour blood pressure monitoring in chronic hemodialysis patients.
abstract: In this study we investigated the interactions between volume changes (body weight), plasma atrial natriuretic peptide (pANP) and ambulatory blood pressure (BP) in 10 patients with end-stage renal disease undergoing regular hemodialysis (HD) treatment three times weekly. Most patients retained their diurnal BP variation when their BP was adequately controlled. Interdialytic weight gain was 1.3 +/- 0.2 kg and the day-time systolic BP increased 12.5 +/- 4.8 mm Hg on the second interdialytic day. pANP did not correlate (r = -0.07, p = 0.85) with this BP elevation, but there was a fairly strong positive correlation (r = 0.61, p = 0.06) between interdialytic weight gain and systolic BP. The mean pANP level decreased from 149.7 +/- 18.2 to 117 +/- 0.1 ng/l during HD and continued its decrease to 83 +/- 12.2 ng/l at 20 h after an HD session. The total decrease from 149.7 +/- 18.2 to 83 +/- 12.2 ng/l was statistically significant (p = 0.001). Since the lowest pANP value was found 20 h after completion of the dialysis session, body weight is a more reliable indicator of volume reduction during HD than pANP. The results indicate that in HD patients weight gain between two dialysis sessions increases the day-time systolic BP but not the diastolic BP. Diurnal BP variation is maintained as long as BP is adequately controlled either by volume control or by drug treatment.
authors.affiliation: Medical School, University of Tampere, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Ojanen
authors.forename: K
authors.initials: K
authors.lastname: Pietilä
authors.forename: A
authors.initials: A
authors.lastname: Pasternack
mesh_terms: D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D001835:Body Weight / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
chemical_list: D009320:Atrial Natriuretic Factor