Adsorption of natriuretic factors in uremia

Seminars in Nephrology
M FranzW H Hörl

Abstract

Patients with end-stage renal disease have a deranged sodium and water homeostasis leading to chronic volume overload. Atrial natriuretic peptides (ANPs) are circulating hormones that are involved in the regulation of volume homeostasis, blood pressure control, and electrolyte balance. In hemodialysis patients plasma ANPs are highly elevated and decrease during the dialysis session when fluid is removed. However, hemodialysis treatment never corrects the defect in the metabolism of these peptides and their circulating concentrations do not return to levels found in healthy controls. Besides uremia and chronic volume overload, other factors such as cardiac dysfunction or hypertension may contribute to the elevated plasma concentrations of ANPs. ProANP fragments which derive from the N-terminus of the ANP prohormone have been also found in the circulation and they have biological functions similar to alpha-ANP (ie, the C-terminus of the prohormone). The proANP peptides proANP(1-30), proANP(31-67), and proANP(1-98) are increased in patients undergoing regular hemodialysis treatment, but their decrease during the dialysis procedure is less pronounced than for alpha-ANP or cyclic GMP. Cellulose triacetate dialyzer membrane material ...Continue Reading

Citations

Feb 13, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Matthias P Hörl, Walter H Hörl
Nov 22, 2005·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Walter H Hörl

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