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Plasma concentrations of immunoreactive-atrial natriuretic polypeptide in patients on hemodialysis.

Plasma concentrations of immunoreactive (IR)-atrial natriuretic polypeptide (ANP) were measured before and after hemodialysis (HD) as well as isolated ultrafiltration (UF) in 9 patients with end-stage renal disease. There were significant falls in plasma concentrations of IR-ANP during both UF (from 78.6 +/- 109.7 to 45.4 +/- 56.8 pg/ml; mean +/- SD; p less than 0.025) and HDs (from 84.7 +/- 48.6 to 35.0 +/- 28.4 (p less than 0.01) on first HD; from 73.7 +/- 74.2 to 31.8 +/- 21.8 pg/ml (p less than 0.01) on later HD). There were distinct positive correlations between blood pressures and plasma concentrations of IR-ANP. These results support the view that ANP is secreted mainly by the expansion of blood volume. The fall in plasma concentrations of IR-ANP after HD seems to be caused by the decrease of blood volume, but not by removal due to dialysis of the peptide. However, the physiological role of ANP in patients with end-stage renal disease remains unknown.