Kuhlmann U, Pal M, Schafer A, Ehlenz A, Lange H
Effects of dialysate sodium variation and ultrafiltration on
ANP, BNP, ADH, and endothelin during haemodialysis
22nd ESAO Congress (Eur Soc Artif Organs)
Int J Artif Organs
(Oct) 18:424 1995
Plasma vasoactive hormone level changes during dialysis were examined as a
function of dialysate sodium level (high, eunatremic, and low). Plasma ANP
(atrial natriuretic peptide) levels increased during dialysis, and the
increase was related to ultrafiltration. BNP (brain natriuretic peptid), ADH
(antidiuretic hormone) and ET (endothelin) levels did not correlate with UF
rate. Plasma ANP levels fell during high sodium dialysis, increasing with
the other treatments. Plasma BNP changes seemed to be related to plasma
sodium more than to UF rate. New and interesting finding included the
observation that plasma ADH and ET levels were increased with high sodium
dialysate more than with the other treatments
Comment: The hormonal observations are interesting, but as yet of
uncertain clinical significance. The study would be much enhanced by
measurements of plasma volume (e.g., using optical on-line hematocrit
monitoring), to permit correlation of blood volume changes with changes of
plasma hormones. Why high sodium dialysate should increase plasma ADH levels
(plasma sodium levels typically change very little) is unclear; the mechanism
requires further study.
(J. Daugirdas)
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22nd ESAO Congress (Eur Soc Artif Organs)
Basic hemodialysis :
Complications (acute)