Abstract
Changes in atrial natriuretic peptide (ANP) concentration were compared in relation to accompanying changes in body weight (BW) and blood pressure (BP) in 10 diabetic (DM) and 10 non-diabetic (non-DM) hemodialysis patients during hemodialysis. ANP, body weight, ultrafiltration rate, BP and various hormones (renin, catecholeamines, angiotensin II, aldosterone) were measured before, at 2 hours and at the end of hemodialysis treatment.
Plasma ANP levels in the DM group were always higher than in the non-DM group during hemodialysis. The percent changes in BW and ANP, and BP values in the non-DM group obtained at 2 hours and at the end of hemodialysis were -2.1 and -26% and 166/90mmHg (2 hours), and -4.02 and -40% and 144/85mmHg (end), respectively. However, a more significant fall in ANP at 2 hours was observed despite the similar decrease in body weight in the DM group, the values of which were -2.1% in ANP and -42% in BW changes, respectively. The BP of the DM group at 2 hours was also lower (142/73mmHg).
The values of the DM group determined at the end of hemodialysis were not different from those of the non-DM group [-4.03% (BW), -41% (ANP) and 130/69mmHg (BP)].
No positive correlations between ANP and any of the hormones determined on the three occasions were demonstrated in either group.
Our results suggest that the differences observed in ANP concentration between non-DM and DM patients are a consequence of fluid loss. This would imply that some unknown factors are involved in changes in the ANP level during hemodialysis, particularly in DM patients.
