Atrial natriuretic peptide in chronic renal failure on maintenance hemodialysis : effect of heart failure


objective: To examine the plasma level of atrial natriuretic peptide(ANP) in patients with
chronic renal failure (CRF) undergoing maintenance hemodialysis ( HD) and to evaluate the
effect of superimposed cardiac functional impairment on the plasma level of this hormone.
Design: A case- series study
Setting: Artificial Kidney and Dialysis Unit of lbn-Sena Teaching Hospital, Mosul; during the
period from June 2003 to August 2004.
Participants: Forty patients with CRF undergoing maintenance HD, were divided into 2 groups depending on presence or absence of heart 6itu[. Group l, includes 20 patients with CRF who did not have heart failure and group Il, includes 20 patients with CRF who had heart failure, The study also includes 20 healthy volunteers as a control group.
Methods: Plasma ANP, serum creatinine, urea and body weights were measured in CRF
patients before and after HD. The same parameters were also measured in the control group.
The paired-t-test was used to examine the difference in the mean of the studied parameters in patients with CRF before and after HD. The unpaired -t- test was used to assess the difference in the mean of the above-mentioned parameters between patients and control group. Pearson correlation coefficient was used to study the relation of the means of differences between pre and post dialysis values of the studied parameters within each patient group.
Results: The mean of plasma ANP level was significantly higher in group I (p<0.0001) and
group ll (p<0.0001) than that in the control group before and after HD. Furthermore, the plasma ANP in group ll was significantly higher (p<0.0001) than that in group I. There was a significant decrease in the plasma ANP in group I (pconclusion: Periodic measurement of plasma ANP level in patients with CRF may be of great
value in evaluating the actual fluid status in patients having CRI and in determination of
frequency and duration of dialysis sessions. lt also may be of value in predicting cardiac
dysfunction in patients with CRF.
Key words: Atrial natriuetic peptide, chronic renal failure, haemodialysis.