Endothelin and Atrial Natriuretic Peptide in Non-Insulin-Dependent Diabetic Versus Nondiabetic Patients on Chronic Hemodialysis
| Autor: | Dietmar Nagel, Monika Falk, Hermann Franz, Guntram Wildburg, Thomas Schleiffer, Michael Stark, Ina Valentiner, Horst Brass |
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| Rok vydání: | 1994 |
| Předmět: |
Male
medicine.hormone medicine.medical_specialty medicine.medical_treatment Blood Pressure Critical Care and Intensive Care Medicine Endothelins Atrial natriuretic peptide Renal Dialysis Internal medicine Blood plasma medicine Humans Renal replacement therapy Dialysis Aged business.industry General Medicine Middle Aged Calcium Channel Blockers Endocrinology Blood pressure Diabetes Mellitus Type 2 Nephrology Kidney Failure Chronic Female Hemodialysis Endothelin receptor business Atrial Natriuretic Factor |
| Zdroj: | Renal Failure. 16:747-758 |
| ISSN: | 1525-6049 0886-022X |
| DOI: | 10.3109/08860229409044904 |
| Popis: | Plasma levels of endothelin (ET) and atrial natriuretic peptide (ANP) are known to be elevated in patients on chronic hemodialysis. Since ET and ANP plasma levels are found to be raised in nonuremic diabetic versus nondiabetic subjects, we wanted to detect a possible difference in plasma levels of these hormones in diabetic versus nondiabetic patients who were on chronic renal replacement therapy. ET is a possible marker of increased vascular atherogenic activity. We measured plasma levels of ET and ANP pre- and posthemodialysis in 23 non-insulin-dependent (NIDDM) diabetic versus 23 nondiabetic patients who were matched according to age and time of day of hemodialysis, and who did not show clinical signs of overt cardiac decompensation. Mean plasma levels of ET and ANP did not differ in diabetic from nondiabetic patients, neither pre- nor postdialysis. In both patient groups, mean ET levels were twice the upper normal limit, did not change significantly pre- versus postdialysis, and did not correlate with blood pressure or with volume ultrafiltration during dialysis. Calcium channel blocker therapy was accompanied by a significant rise of ET pre- and postdialysis in nondiabetic patients but not in diabetic patients. In diabetic patients, ET plasma levels correlated positively with fructosamine levels as an indicator of short-term blood glucose control. Mean ANP plasma levels were about three times the upper normal limit and decreased significantly during dialysis, but this decrease correlated neither with volume ultrafiltration nor with blood pressure. In conclusion, we could not find a difference in plasma levels of ET and ANP for diabetic versus nondiabetic dialysis patients, but impaired short-term blood glucose control in diabetic and calcium channel blocker therapy in only nondiabetic dialysis patients showed concomitant increases in plasma ET levels and thus possibly different mechanisms of ET regulating pathways. |
| Databáze: | OpenAIRE |
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