Long-acting natriuretic peptide, vessel dilator, and kaliuretic peptide enhance urinary excretion rate of albumin, total protein, and beta(2)-microglobulin in patients with congestive heart failure.

Abstract

BACKGROUND:

Albumin excretion is increased in persons with congestive heart failure (CHF), but the mechanism of this increase is unknown. Atrial natriuretic peptide (ANP) does not correlate with this albumin excretion, but the other 3 cardiac hormones derived from the ANP prohormone have never been investigated as to whether they can enhance albumin and/or protein excretion in persons with CHF.

METHODS AND RESULTS:

Long-acting natriuretic peptide (LANP), vessel dilator, and kaliuretic peptide (100 ng/kg body weight/min) given intravenously for 60 minutes to NYHA Class III CHF patients (n = 24) increased the albumin excretion rate 2- to 7-fold (P <.001) and total protein excretion rate 2- to 5-fold (P <.001). These peptide hormones similarly enhanced beta(2)-microglobulin, a specific marker of proximal tubular reabsorption, excretion rate 25- to 40-fold (P <.0005) at the end of their respective infusions. Three hours after stopping their respective infusions, the beta(2)-microglobulin excretion rate was still 11- to 33-fold (P <.0005) increased.

CONCLUSIONS:

LANP, vessel dilator, and kaliuretic peptide each enhance albumin and total protein excretion in persons with CHF. Part of the mechanism of this enhanced protein excretion is the inhibition of proximal tubular reabsorption of protein as shown by the beta(2)-microglobulin data.

• Authors: D L Vesely, G I Perez-Lamboy, D D Schocken
• Journal: Journal of cardiac failure (J Card Fail) Vol. 7 Issue 1 Pg. 55-63 (Mar 2001) ISSN: 1071-9164 [Print] United States
• PMID: 11264551 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Peptide Fragments
• Protein Precursors
• Vasodilator Agents
• atrial natriuretic factor precursor (79-98)
• atrial natriuretic factor prohormone (1-30), human
• beta 2-Microglobulin
• Atrial Natriuretic Factor

Topics

• Adult
• Aged
• Albuminuria (metabolism)
• Atrial Natriuretic Factor (pharmacology)
• Heart Failure (metabolism, urine)
• Humans
• Kidney Tubules, Proximal (metabolism)
• Male
• Middle Aged
• Peptide Fragments (pharmacology)
• Protein Precursors (pharmacology)
• Proteinuria (metabolism)
• Vasodilator Agents (pharmacology)
• beta 2-Microglobulin (urine)