Effects of renal perfusion pressure on the natriuresis induced by atrial natriuretic factor

Seymour, A A; Smith, Shaler G.; Mazack, E K

doi:10.1152/ajprenal.1987.253.2.f234

Cited by 27 publications

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“…It has been reported that ANF is released in response to volume distention of the extracellular space (1 9). ANF acts on the glomerular membranes to oppose angiotensin 11, to directly increase permeability resulting in the glomerulotubular balance toward natriuresis, or to modulate the prevailing levels of renal perfusion pressure and renal vascular resistance (10,20,21). Recently, Manning et al…”

Section: Resultsmentioning

confidence: 99%

Changes in Vasopressin, Atrial Natriuretic Factor, and Water Homeostasis in the Early Stage of Bronchopulmonary Dysplasia

et al. 1990

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ABSTRACT. Arginine vasopressin (AVP), atrial natriuretic factor, and water balance were examined in the infants with or without bronchopulmonary dysplasia (BPD) during the first 4 wk of life. Fourteen premature infants, nine in the early stage of BPD secondary to respiratory distress syndrome (BPD infants) and five healthy low birthwt infants (LBW infants), were the subjects of this study. The water and sodium balance, renal function, and plasma AVP and atrial natriuretic factor concentrations were determined during the first 4 wk of life. Plasma AVP and atrial natriuretic factor levels of BPD infants at the 4th wk of life were higher than those of LBW infants at the corresponding age. Urine osmolality was higher and free water clearance was lower in BPD infants at the 4th wk of life when compared with each parameter in LBW infants, respectively. Pac02 of BPD infants at the 4th wk of life was more elevated than that of LBW infants. These results suggest that elevated plasma AVP level may be related with pulmonary abnormalities and that atrial natriuretic factor may hence compensate the water retention resulted from the functionally activated AVP in the early stage of BPD. (Pediatr Res 27: [260][261][262][263]1990) Abbreviations ANF, atrial natriuretic factor AVP, arginine vasopressin BPD, bronchopulmonary dysplasia Ccr, creatinine clearance CH20, free water clearance FENa, fractional excretion of sodium LBW, low birthwt RDS, respiratory distress syndrome SIADH, syndrome of inappropriate secretion of antidiuretic hormoneInfants with chronic BPD sometimes develop edema, oliguria, and hyponatremia (1-3). Some of these symptoms are similar to those seen in patients with SIADH (4, 5). Recently, Hazinski et al. (2) found that some infants with chronic BPD have elevated plasma AVP levels and they speculated the functional significance of these elevated values. However, all these articles are about water balance in the chronic stage of BPD. It has not been well established whether the changes of plasma AVP levels and water balance in the early stage of BPD are the same with those in chronic BPD.On the other hand, ANF, found and isolated from the heart, has potent natriuretic and diuretic activities ( 6 4 , even in the premature infants (9). Among a variety of physiological effects of ANF such as natriuresis, vasodilation, inhibition of aldosterone release (6, lo), it is suggested that ANF suppresses the AVP release (1 1, 12). We therefore investigated whether there are differences in plasma values of AVP, ANF, and water homeostasis during the 1st mo of life between infants in the early stage of BPD and healthy LBW infants. MATERIALS AND METHODSStudy protocol. Fourteen premature infants (eight boys and six girls), nine in the early stage of BPD secondary to RDS (BPD infants) and five LBW infants, were the subjects of this study. Informed consent was obtained from each patient's parents. Our definition of BPD was based on three criteria: requirement of positive pressure ventilation as treatment for RDS in the 1st wk of...

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Section: Resultsmentioning

confidence: 99%

Changes in Vasopressin, Atrial Natriuretic Factor, and Water Homeostasis in the Early Stage of Bronchopulmonary Dysplasia

et al. 1990

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“…These effects are consistent with potentiation of the effect of endogenous ANF on the kidney and are impressive, given the fact that blood pressure most likely was reduced in these rats and the natriuretic response to ANF is dependent on an adequate renal arterial perfusion pressure. 25 Others have reported significant diuresis with the NEP inhibitors phosphoramidon and UK 69S78. 26 .…”

Section: Discussionmentioning

confidence: 99%

Atrial natriuretic factor-potentiating and antihypertensive activity of SCH 34826. An orally active neutral metalloendopeptidase inhibitor.

Sybertz¹,

Chiu²,

Vemulapalli³

et al. 1990

Hypertension

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“…19 The modulating role of renal perfusion pressure on the natriuresis induced by ANP has also been demonstrated in experimental studies. For example, Seymour et al 20 showed that stepped reductions in renal perfusion pressure resulted in a progressive fall in the fractional excretion of sodium during ANP administration. It is suggested that a higher renal perfusion pressure in hypertensive patients is required to maintain sodium balance 7 ' 16 and may account for the failure to find elevated plasma ANP levels in uncomplicated hypertension.…”

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Insulin blunts the natriuretic action of atrial natriuretic peptide in hypertension.

et al. 1994

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Hyperinsulinemia and insulin resistance are implicated in the etiology of hypertension, but the mechanisms involved have not been established. The objectives of this study were to determine whether untreated essential hypertensive patients are more sensitive to the antinatriuretic action of insulin and more resistant to the counteracting natriuretic effect of atrial natriuretic peptide in contrast to age-and sex-matched normotensive control subjects. Urinary sodium excretion was measured at baseline, during hyperinsulinemic euglycemic clamp, and during coadministration of insulin and atrial natriuretic peptide. Baseline urinary sodium excretion was not significantly different in the normotensive subjects (415±47 ^mol/min, n = 12) and hypertensive patients (381±18 junol/min, n=10); with the institution of insulin infusion, there was a similar and significant decline from baseline (P<.001) to 289±35 /unol/min in normotensive subjects and 235±17 in hypertensive patients. In studies we performed on healthy human subjects, the coinfusion of insulin and atrial natriuretic peptide (ANP) in a low dose completely abolished the well-described antinatriuretic action of insulin. 8 The same dose of ANP alone, however, had no effect on urinary sodium excretion (U N ,V). We concluded that hyperinsulinemia alone is unlikely to cause hypertension because any tendency for sodium retention would ultimately stimulate ANP release and return sodium balance to normal, thus maintaining euvolemia and normal blood pressure (BP) levels. If hyperinsulinemia has an etiologic role in hypertension mediated in part through alterations in sodium balance, then there must be either exaggerated sodium retention in response to insulin or attenuation of the renal "escape" mechanisms.The purpose of this study was to assess the relation between ANP and insulin in essential hypertension. The specific aims were to examine whether the antinatriuretic response to hyperinsulinemia is enhanced in Correspondence to Dr Alexander G. Logan, Suite 850, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 600 University Ave, Toronto, Ontario, Canada M5G 1X5. was able to oppose the antinatriuretic action of insulin in normotensive subjects, increasing urinary sodium excretion significantly to a mean level of 352±31 jimol/min (f<.05), which did not differ significantly from baseline. In the hypertensive group, atrial natriuretic peptide infusion had no effect on urinary sodium excretion (238±18 ^mol/min), and the difference from baseline remained highly significant (P<.001). The hypertensive patients were significantly less insulin sensitive than their normotensive counterparts, as reflected by a lower glucose utilization rate and higher mean baseline plasma insulin level (F<.05 for each). We conclude that resistance to the natriuretic action of atrial natriuretic peptide may be a pathogenetic link between insulin resistance and hypertension. essential hypertension and whether A N P can counteract the sodium-retaining action of insulin in hypertensiv...

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Effects of renal perfusion pressure on the natriuresis induced by atrial natriuretic factor

Cited by 27 publications

References 0 publications

Changes in Vasopressin, Atrial Natriuretic Factor, and Water Homeostasis in the Early Stage of Bronchopulmonary Dysplasia

Changes in Vasopressin, Atrial Natriuretic Factor, and Water Homeostasis in the Early Stage of Bronchopulmonary Dysplasia

Atrial natriuretic factor-potentiating and antihypertensive activity of SCH 34826. An orally active neutral metalloendopeptidase inhibitor.

Insulin blunts the natriuretic action of atrial natriuretic peptide in hypertension.

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