The effect of atrial natriuretic factor on urinary albumin and ??; 2-microglobulin excretion in man

McMurray, John J.; Seidelin, Peter H.; Howey, Jacqui E.A.; Balfour, David J.K.; Struthers, Allan D.

doi:10.1097/00004872-198810000-00003

Cited by 28 publications

(22 citation statements)

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“…Similar results have been reported in patients with nephrotic syndrome [1] and healthy subjects [2], Such a proteinuric effect was observed at several hundred picograms per milliliter of plasma ANP concentration, a level much higher than the physiological level, suggesting the pharmacological ef fects of ANP. However, we have already reported [11] that the plasma concentration of ANP in patients with endstage renal failure and those with congestive heart failure sometimes exceeds the plasma level attained during ANP infusion in this study.…”

Section: Discussionsupporting

confidence: 86%

“…However, we have already reported [11] that the plasma concentration of ANP in patients with endstage renal failure and those with congestive heart failure sometimes exceeds the plasma level attained during ANP infusion in this study. Therefore, since the proteinuric effect was observed even in normal subjects [2]: this peptide may have some pathophysiological role with respect to proteinuria when ANP secretion is markedly elevated.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the relation between this peptide and protein uria was implicated in both nephrotic patients [I] and healthy persons [2]. We have also reported that exoge nous ANP infusion markedly increases urinary protein excretion in patients with primary glomerular disease [3]; however, the mechanism has not yet been elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Atrial Natriuretic Peptide on Urinary Protein Excretion in Mesangial Proliferative Glomerulonephritis

Hirata

Ishii²,

Fukui³

et al. 1991

Nephron

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Atrial natriuretic peptide (ANP) increases proteinuria in primary glomerular disease. To study whether mesangial proliferation influences this effect, we infused α-human ANP at 25 ng/kg/min for 40 min into 6 patients with minor glomerular abnormalities (MGA), 10 with focal glomerulonephritis (FGN) and 8 with diffuse glomerulonephritis (DGN), and determined its renal effects. ANP significantly increased urinary excretions of Na and protein in all groups. Increases in urinary Na excretion were comparable among the groups (about + 200%), while increases in urinary protein excretion were greater in DGN than in the other two groups (DGN +153 μg/min/1.73 m², MGA + 77 μg/min/1.73 m², FGN +70 μg/min/1.73 m²). This increase was not related to the preinfusion level of proteinuria. Furthermore, the ratio of urinary protein to creatinine was significantly elevated by about 250% in the three groups. Thus, ANP seems to increase the permeability of the glomerular basement membrane to protein, particularly in patients with DGN, possibly through mesangial proliferation and the associated changes in adjacent tissues.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Effects of Atrial Natriuretic Peptide on Urinary Protein Excretion in Mesangial Proliferative Glomerulonephritis

Hirata

Ishii²,

Fukui³

et al. 1991

Nephron

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“…Quite unexpectedly, however, the statistical link between the 2 parameters was independent of pressure, a result also recently reported by Gatzka et al 38 The data might perhaps be explained by circulating factors that are produced in greater amount by a hypertrophic heart 39 and by an increasing renal permeability to albumin. 40 This interesting possibility requires further evaluation in future studies.…”

Section: Discussionmentioning

confidence: 97%

Microalbuminuria and Pulse Pressure in Hypertensive and Atherosclerotic Men

et al. 2000

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Abstract-To identify the biological covariates of microalbuminuria (albuminuria Ն15 g/min) in nondiabetic subjects, brachial blood pressure, echocardiographic left ventricular mass, and other cardiovascular and metabolic parameters were evaluated in 211 untreated males (38 normal controls, 109 uncomplicated stage 1 to 3 essential hypertensives, and 64 patients with clinically stable atherosclerotic peripheral vascular disease either with [nϭ44] or without [nϭ20] essential hypertension) with normal cardiac and renal function. Compared with normoalbuminuric subjects, microalbuminuric subjects (nϭ67) were characterized by higher systolic blood pressure, comparable diastolic blood pressure, and, therefore, wider pulse pressure. Greater prevalence of hypertension, peripheral vascular disease, left ventricular hypertrophy, and reduced HDL cholesterol values further distinguished microalbuminuric from normoalbuminuric subjects in univariate comparisons. The risk of microalbuminuria increased by ascending pulse pressure quintiles in age-corrected logistic regression models, in which pulse pressure was more predictive than systolic pressure and was independent of mean pressure. When microalbuminuric status was regressed against a series of dichotomous (vascular and active smoker status) and continuous (age, pulse and mean pressure, left ventricular mass index, and HDL and LDL cholesterol) variables, only pulse pressure, left ventricular mass index, and smoking status were independent predictors. The association of increased albuminuria with wider pulse pressure, a correlate of the pulsatile hemodynamic load and conduit vessel stiffness as well as an important cardiovascular risk factor, may explain why microalbuminuria predicts cardiovascular events in nondiabetic subjects. The independence from concomitant vascular disease also suggests that wider pulse pressure, rather than representing a simple marker for atherosclerotic disease, influences albuminuria directly. To specify to a better extent the biological covariates of microalbuminuria in nondiabetic subjects, we have evaluated cross-sectionally a series of cardiovascular and metabolic parameters in a large group of normal control subjects, subjects with essential hypertension (EH), and patients with atherosclerotic vascular disease. Methods SubjectsThe study was carried out on 211 eligible sedentary subjects referred to our unit from 1996 to 1998 for screening and treatment of hypertension and related cardiovascular risk factors. Inclusion criteria required male gender, negative urine dipstick test, normal urinary sediment and renal ultrasound, plasma glucose Ͻ7.8 mmol/L (120 mg/dL), serum creatinine Ͻ110 mol/L (1.4 mg/dL), total serum cholesterol Ͻ7.8 mmol/L (300 mg/dL), body mass index (BMI) Ͻ27 kg/m 2 , and preserved systolic cardiac function (ejection fraction Ͼ50%) (see Table 1 for the overall demographic and clinical characteristics). One hundred nine patients had stage 1 to 3 uncomplicated EH, 20 had atherosclerotic peripheral vascular disease (PVD), and 44 w...

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“…14,49,50 This behaviour, again consonant with the nature of microalbuminuria as an integrated risk marker, suggests direct influences of the heart on UAE. An obvious candidate to that role is the atrial natriuretic peptide (ANP), a natriuretic and albuminuric hormone 125 produced in greater quantities by a hypertrophic ventricle, 126 a plausible hypothesis needing confirmation, however. Whatever the case, pressureindependent links with left ventricular hypertrophy, in itself a marker and/or risk factor of hypertensionrelated clinical events above and beyond BP levels, 127 should be kept in mind to interpret the predicting power of microalbuminuria for morbidity and mortality.…”

Section: Left Ventricular Hypertrophymentioning

confidence: 99%

Microalbuminuria, an integrated marker of cardiovascular risk in essential hypertension

et al. 2002

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This paper reviews the existing epidemiological and clinical evidence about the relationships of non-diabetic microalbuminuria with cardiovascular risk factors such as elevated blood pressure (BP), systolic particularly, cardiac hypertrophy, adverse metabolic status, smoking habits, elevated angiotensin II levels, endothelial dysfunction, acute and perhaps subclinical inflammation. Because of that unique property of reflecting the influence of so many clinically relevant parameters, microalbuminuria may legitimately be defined as an integrated marker of cardiovascular risk, an unique profile among the several prognostic predictors available to

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The effect of atrial natriuretic factor on urinary albumin and ??; 2-microglobulin excretion in man

Cited by 28 publications

References 0 publications

Effects of Atrial Natriuretic Peptide on Urinary Protein Excretion in Mesangial Proliferative Glomerulonephritis

Effects of Atrial Natriuretic Peptide on Urinary Protein Excretion in Mesangial Proliferative Glomerulonephritis

Microalbuminuria and Pulse Pressure in Hypertensive and Atherosclerotic Men

Microalbuminuria, an integrated marker of cardiovascular risk in essential hypertension

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