Document Detail

Clinical significance of natriuretic peptides and cyclic GMP in hemodialysis patients with coronary artery disease.
MedLine Citation:
PMID:  11359018     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Plasma concentrations of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and cyclic guanosine monophosphate (cGMP) are suitable markers of 'dry body weight' (DW) in hemodialysis (HD) patients. However, it is still unknown whether these markers can be applied to patients with renal failure and coronary artery disease (CAD). We examined the reliability of these peptides as volume markers in HD patients with CAD. We also assessed the relationship between natriuretic peptides and indices of left ventricular (LV) function. METHODS: Plasma concentrations of ANP, BNP and cGMP were determined before and after HD in patients with CAD (group 1, n = 19, mean age 63 +/- 12 years) and were compared with those of patients without cardiac disease (group 2, n = 20, age 61 +/- 15 years). Using data obtained by cardiac catheterization, we examined the relationship between natriuretic peptides and indices of LV function in HD patients with CAD. RESULTS: Baseline ANP (244 +/- 205 pg/ml), BNP (713 +/- 928 pg/ml) and cGMP (29.6 +/- 21.6 pmol/ml) were significantly higher in group 1 than in 11 healthy volunteers (18.6 +/- 9.9 pg/ml, 7.7 +/- 7.6 pg/ml, cGMP 8.9 +/- 4.9 pmol/ml, respectively). HD significantly reduced plasma ANP (87 +/- 75 pg/ml) and BNP (477 +/- 702 pg/ml) although they were still above normal control. HD reduced plasma cGMP (7.2 +/- 4.5 pmol/ml) to normal values, suggesting the elimination of cGMP across the dialyzers. Baseline levels of ANP, BNP and cGMP in group 2 were less than those of group 1 but higher than the control. HD reduced natriuretic peptides in group 2 to levels lower than those in post-HD group 1. After HD, there was no significant correlation between reductions in body weight and changes in ANP or BNP. Baseline ANP and BNP levels closely correlated with pulmonary artery pressure, pulmonary artery wedge pressure, left ventricular end-diastolic pressure and left ventricular ejection fraction. A significant correlation was observed between BNP levels and the severity of CAD. CONCLUSION: ANP, BNP and cGMP seem to be a useful markers for fluid overload but not for DW in HD patients with CAD. Plasma ANP and BNP might be useful markers for left ventricular function.
A Osajima; M Okazaki; H Kato; H Anai; Y Tsuda; K Segawa; H Tanaka; M Tamura; M Takasugi; Y Nakashima
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of nephrology     Volume:  21     ISSN:  0250-8095     ISO Abbreviation:  Am. J. Nephrol.     Publication Date:    2001 Mar-Apr
Date Detail:
Created Date:  2001-05-18     Completed Date:  2001-08-02     Revised Date:  2007-02-14    
Medline Journal Info:
Nlm Unique ID:  8109361     Medline TA:  Am J Nephrol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  112-9     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel
Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
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MeSH Terms
Atrial Natriuretic Factor / blood*
Biological Markers / blood*
Coronary Disease / blood*,  complications
Cyclic GMP / blood*
Kidney Failure / blood,  complications
Middle Aged
Natriuretic Peptide, Brain / blood*
Renal Dialysis*
Stroke Volume / physiology
Ventricular Function, Left / physiology
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain; 7665-99-8/Cyclic GMP; 85637-73-6/Atrial Natriuretic Factor

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