Influence of hemodialysis on intravascular volume and vasoactive hormones

Citation
Ks. Katzarski et al., Influence of hemodialysis on intravascular volume and vasoactive hormones, CLIN NEPHR, 52(5), 1999, pp. 304-311
Citations number
40
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology","da verificare
Journal title
CLINICAL NEPHROLOGY
ISSN journal
0301-0430 → ACNP
Volume
52
Issue
5
Year of publication
1999
Pages
304 - 311
Database
ISI
SICI code
0301-0430(199911)52:5<304:IOHOIV>2.0.ZU;2-N
Abstract
Background: The posthemodialysis plasma level of atrial natriuretic peptide (ANP) has been proposed as an index for an adequate fluid state in hemodia lysis (HD) patients. Patients and methods: We investigated the effect of fl uid removal during HD on the interaction between intravascular volume and t he vasoactive hormones ANP, vasopressin, adrenaline, noredrenaline, renin a nd aldosterone in 16 HD patients. Intravascular volume was examined with th e I-131-labeled albumin method for blood volume (BV) and ultrasound for mea surement of inferior vena cava diameter (IVCD). Results: There was a signif icant decrease in BV, IVCD and ANP. but not in the other vasoactive hormone s. Based on BV and IVCD measurements, the predialysis plasma ANP levels in the normovolemic and hypovolemic patients were significantly higher than in the hypervolemic patients. There was no significant difference between the postdialysis ANP levels in the hypervolemic and normovolemic patients and no significant correlations between ANP and BV and IVCD, respectively, but postdialysis ANP correlated significantly with the ultrafiltration rate (r = -0.51, p < 0.05), noradrenaline (r = 0.54, p < 0.05) and change in vasopr essin (r = -0.50. p < 0.05). There were also correlations between ANP and a ge before HD (r = 0.50, p < 0.05) and after HD (r = 0.70, p < 0.0025). Conc lusion: We conclude that the usefulness of the plasma ANP level for assessm ent of the fluid state in HD patients is limited, since age and other facto rs than those directly related to volume influence the concentration of ANP .