Plasma Atrial Natriuretic Factor (αanf) During Hemodialysis (HD) and Hemofiltration (HF)

Abstract

Plasma concentrations of immunoreactive αANF were measured before, during, and after 3 hours of hemodialysis (HD) and hemofiltration (HF). In seven healthy subjects plasma αANF concentrations were measured to serve as controls. Highly elevated pre-treatment αANF levels were obtained in the HD group (286±52 pg/ml, mean ± SE). and in the HF group (275±48 pg/ml) as compared with the controls (40±3 pg/ml). The effect of both HD and HF on the αANF concentration was not significant after the first hour of treatment. However, a significant decrease was obtained after the second (HD=244±49, HF=140±17) and third hours (HD= 244±48, HF=135±15) (p < 0.05) in both treatments. A steeper decline in the αANF concentration was notable during HF compared with HD. There was a significant difference (p < 0.05) when both modalities were compared at the end of treatment. A correlation (r² = 0.98, p < 0.001) was noted between changes in the αANF levels and the ultrafiltration (UF) volumes only during HF. Plasma αANF concentrations at the filter outlet were lower than at the inlet in both groups. It is concluded that the plasma αANF concentrations are highly elevated in chronic renal failure patients. Despite the decrease in these concentrations during HD and HF it did not reach the normal plasma level. Monitoring of plasma αANF may be a useful indicator for the extracellular volume status during HD and HF treatments.

Key Words:

• αANF
• chronic renal failure
• hemodialysis
• hemofiltration