Cianciaruso B, Bellizzi V, Minutolo R, Iavarone MP, Andreucci M, De Nicola L, Conte G
Diuretic efficacy of low dose atrial natriuretic peptide (ANF) in CRF
33rd Congress of the Eur Dial Transplant Assoc
Nephrol Dial Transplant (Jun) 11:A139 1996

Hypotension and renal hypoperfusion may limit the diuretic efficacy of ANF. In this study it was tested the effect of low-dose ANF (16 ng/Kg for 1h) in 8 patients with chronic renal failure (GFR 43(5 ml/min) secondary to glomerular diseases (CRF patients).

ANF plasma levels showed a more marked rise in CRF patients than in healthy subjects (from 26 to 160 pg/ml Vs 14 to 102 pg/ml). Arterial pressure, GFR and RPF did not change in either group. ANF caused a similar increase in sodium excretion in CRF patients (from 0.12 to 0.42 mEq/min) and in healthy subjects ( from 0.09 to 0.49 mEq/min). The inhibition of tubular Na reabsorption a well as the fractional excretion of cGMP, the second messenger of ANF, were more pronounced in CRF patients than in healthy subjects. In both groups ANF induced urinary loss of potassium, phosphate and urea and reduced the plasma concentration of these substances.

Comment: These data suggest that low-dose ANF may be the ideal diuretic agent in patients with mild to moderate renal failure (Carmine Zoccali, M.D., Reggio Calabria, Italy).

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33rd Congress of the Eur Dial Transplant Assoc
H: Pathophysiology : Kidney in hypertension
H: Drug therapy : Diuretics