Fluid balance in patients with chronic renal failure assessed with N-terminal proatrial natriuretic peptide, atrial natriuretic peptide and ultrasonography

• Published in: Acta physiologica Scandinavica 2001-02, Vol.171 (2), p.117-122
• Main Authors: Metry, G., Hall, C., Wikström, B., Källskog, V., Hansell, P., Danielson, B.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; ANP; Atrial Natriuretic Factor - blood; Biological and medical sciences; cGMP; Creatinine - blood; Cyclic GMP - blood; Emergency and intensive care: renal failure. Dialysis management; Female; haemodialysis; Humans; hydration; inferior vena cava; Intensive care medicine; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - diagnostic imaging; Kidney Failure, Chronic - therapy; Male; Medical sciences; MEDICIN; MEDICINE; Middle Aged; N-terminal proANP; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Prognosis; Protein Precursors - blood; Reference Values; Renal Dialysis; Renal failure; Ultrasonography; Vena Cava, Inferior - diagnostic imaging; Water-Electrolyte Balance
• ISSN: 0001-6772; 1365-201X; 1365-201X
• DOI: 10.1046/j.1365-201x.2001.00792.x

The N‐terminal proatrial natriuretic peptide (proANP) has become an important parameter for assessing the prognosis of patients with cardiac disease. Its use for evaluating the hydration status in patients with chronic renal failure, however, is still under investigation. The present study comprised 12 haemodialysis (HD) and 17 pre‐dialysis patients. In the HD patients, the inferior vena cava diameter during quiet expiration (IVCe) was estimated by ultrasonography and plasma concentrations of N‐terminal proANP, atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) were measured before and 4 h after termination of HD. In the pre‐dialysis patients venous blood samples were taken during rest to measure plasma N‐terminal proANP and ANP and serum creatinine. Normal values for N‐terminal proANP and ANP were obtained from 18 healthy volunteers. The plasma concentrations of N‐terminal proANP and ANP in healthy volunteers were 328 ± 92 and 11.4.0 ± 3.1 p M L−1, respectively. In pre‐dialysis patients, serum creatinine ranged from 110 to 447 μM L−1 and was significantly correlated to plasma N‐terminal proANP (r=0.60, P