Expansion of extracellular fluid volume,--increasing right atrial pressure,--appears to be a major stimulus for the rise in plasma
atrial natriuretic peptide (
ANP).
End-stage renal disease (
ESRD) is associated with significant changes of several
hormone systems. Recent studies have shown that plasma
ANP concentration is significantly increased in patients with
ESRD and that the concentration of the
hormone declines following haemodialysis (HD). In patients with
ESRD treated by HD "dry weight" for each individual patient is the
body weight at which the patients has normal hydration status. The aim of the present study was to determine changes of plasma concentrations of
ANP during haemodialysis. We also attempted to check whether the baseline levels of
ANP were related to
weight loss during dialysis. Eleven children (7 females, 4 males) participated in the study. The patients age related from 8 to 20 years. Plasma concentrations were markedly elevated (p < 0.01) before haemodialysis (251 ae 119) pg/ml) in comparison with control values (61 ae 23 pg/ml), but remained above normal range in all except 4 cases. During HD
body weight was reduced in all but one patient. This patient was infused isotonic fluid during HD and did not show
weight loss. The four patients who had normal plasma
ANP levels at the end of treatment appeared to be in better overall condition than the other patients. In summary, plasma
ANP measurements may be of value in establishing the volume status in patients with
ESRD. Plasma
ANP levels after HD may help to adjust the right dry
body weight for each patient.