Atrial natriuretic peptide[ANP] in hemodialysis: effect of dialysate sodium concentration and duration of dialysis

ABSTRACT

This work was planned to Study the effect of duration of chronic renal failure and hemodialysis on cardiac release of atrial natriuretic peptide [ANP]. Twenty patients with end stage renal failure were categorized into two groups group I included 10 patients on-regular hemodialysis for more than five years duration and group II comprised 10 patients on regular hemodialysis for less than one year; patients in group II were dialyzed under high sodium dialysate and low sodium dialysate. Predialysis levels of ANP in group I and II were higher than that of the control group, however, higher levels were observed in group II. At the end of dialysis, both groups [I, II] showed significant ANP decrease compared to predialysis levels but did not return to normal control values. Group II, dialyzed under high sodium dialysate, showed higher predialysis ANP levels than those dialyzed under low sodium dialysate. On the other hand postdialysis decrease in ANP was more evident in those under low sodium dialysate. It could be concluded that ANP is elevated in chronic renal failure, long term hemodialysis might lead to blunted response of atrial cardiocytes to release ANP. Early renal transplantation in end stage renal failure is mandatory to keep a constant internal enviroment