atrial-natriuretic-factor and Venous-Insufficiency

The exact role of atrial natriutetic peptide (ANP) in the pathogenesis of edema in nephrotic syndrome (NS) has not been fully elucidated. We aimed to investigate the possible contribution of ANP to edema formation in NS.. We subjected 18 nephrotic subjects and 20 healthy volunteers to supine bicycle exercise (SBE), a maneuver that seemed to increase venous return and to enhance the release of ANP. Plasma concentrations of immunoreactive-ANP were measured before and after SBE by radioimmunoassay.. There was a significant rise in the plasma concentration of ANP in the controls after SBE (from 31.1 +/- 6.16 to 42.0 +/- 6.01 pg/ml: p < 0.05). Meanwhile, there was no change in plasma concentration of ANP in the patients with NS (from 35.4 +/- 6.04 to 35.1 +/- 5.31 pg/ml). The change in plasma concentration of ANP in controls was significantly different from that in those with NS (p < 0.05). The mean baseline value of ANP in controls was the same as in NS.. These results show that SBE was a simple maneuver to stimulate the release of ANP in healthy controls. In contrast, it failed to stimulate the release of ANP in subjects with NS.

Topics: Adolescent; Adult; Atrial Natriuretic Factor; Exercise; Female; Humans; Male; Middle Aged; Nephrotic Syndrome; Radioimmunoassay; Supine Position; Venous Insufficiency

Topics: Aged; Aged, 80 and over; Atrial Natriuretic Factor; Bandages; Blood Pressure; Female; Heart Failure; Heart Rate; Humans; Male; Middle Aged; Reference Values; Varicose Ulcer; Venous Insufficiency

To investigate the effects of postural changes and upright exercise on atrial natriuretic peptide release and renin-angiotensin-aldosterone system behavior in patients with venous valvular insufficiency, plasma ANP, plasma renin activity and aldosterone were measured in 11 patients with venous disease and in 11 age-matched controls. In patients with large varicose veins and venous valvular dysfunction, standing was associated with a greater fall in circulating ANP levels (p < 0.05) and upright exercise was accompanied by a smaller rise in ANP concentrations (p < 0.05) as compared with controls. A significant (p < 0.001) inverse relationship was found between the number of venous segments with reflux and both upright and exercise plasma ANP concentrations (r = -0.91; r = -0.84, respectively). In the two groups the response of the renin-angiotensin-aldosterone system to upright position and physical stress was similar. These results suggest that a decreased atrial stretch, due to a reduced venous return, could account for the blunted ANP response to erect posture and exercise in patients with venous valvular incompetency.

Topics: Adult; Aldosterone; Atrial Function; Atrial Natriuretic Factor; Exercise; Female; Humans; Male; Posture; Radioimmunoassay; Renin; Renin-Angiotensin System; Venous Insufficiency