atrial-natriuretic-factor and Glomerulonephritis--IGA

In this study, we measured plasma and urinary adrenomedullin (AM) concentrations in 47 patients with IgA nephropathy. Controls were 39 healthy volunteers. Plasma and urinary AM values were measured by specific radioimmunoassay. The plasma AM concentrations were higher, and the urinary AM levels were lower in patients with IgA nephropathy than in healthy volunteers. Plasma AM concentrations showed a positive correlation with serum creatinine and blood urea nitrogen, whereas urinary AM levels correlated negatively with serum creatinine and blood urea nitrogen. The plasma AM concentrations showed a positive correlation with fractional excretions of sodium and potassium. Renal biopsy specimens of patients without renal failure were scored for activity (percentage of glomeruli demonstrating cellular crescent formation, degree of mesangial proliferation and interstitial infiltration; total score = 9). Urinary AM levels were shown to be lower in the group with a high activity (score 3-9) as compared with the group with a low activity (score 0-2) based on renal biopsy. Thus, urinary levels of AM are affected by the degree of the activity in IgA nephropathy, and AM may participate in the pathophysiology of IgA nephropathy.

Topics: Adrenomedullin; Adult; Aged; Atrial Natriuretic Factor; Blood Urea Nitrogen; Creatinine; Glomerulonephritis, IGA; Humans; Middle Aged; Natriuretic Peptide, Brain; Nerve Tissue Proteins; Peptides; Radioimmunoassay

The plasma concentration of the immunoreactive (IR) human atrial natriuretic factor (hANF) was measured in 17 patients with primary IgA nephropathy (IgAN) (9 normotensive and 8 hypertensive subjects without impairment of renal function). Furthermore, correlations with the renin-angiotensin II-aldosterone system and hemodynamic alterations were studied. The mean value of IR-hANF was significantly (p less than 0.002) higher in normotensive IgAN patients (68.2 +/- 14.6 pg/ml) than in controls (48.8 +/- 11.5 pg/ml), while it was slightly and not significantly elevated in hypertensive IgAN patients (58.5 +/- 8.4 pg/ml). In the latter the mean plasma renin activity (PRA) was significantly increased (0.92 +/- 0.30 ng/ml/h; p less than 0.002), while in normotensive IgAN patients (0.68 +/- 0.58 ng/ml/h) no difference was observed. Plasma aldosterone levels showed the same behavior pattern as those of PRA. Hemodynamic studies showed that the mean values of the cardiac index (CI) were significantly (p less than 0.002) high in both normotensive (3.55 +/- 0.5 l/min/m2) and hypertensive (3.32 +/- 0.47 l/min/m2) patients, while a significant reduction in the total peripheral resistance index (TPRI) in normotensive (2171 +/- 349 dyn/s/cm-5/m2; p less than 0.02) and a significant increase in hypertensive (2959 +/- 440 dyn/s/cm-5/m2; p less than 0.05) patients were observed. The mean arterial pressure (MAP) had a positive correlation with the TPRI and an inverse correlation with the IR-hANF.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Atrial Natriuretic Factor; Female; Glomerulonephritis, IGA; Hemodynamics; Humans; Hypertension, Renal; Male; Radioimmunoassay; Renin-Angiotensin System