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Disturbance in sodium regulating hormones in chronic obstructive uropathy
N W Clarke1, D A Jones, F Tames
1Department of Urological Surgery, Withington Hospital, Manchester.
British Journal of Urology
|August 1, 1991
Summary
In high pressure chronic retention of urine (HPCR), elevated atrial natriuretic peptide (ANP) normalized after urinary tract decompression. Hormonal changes suggest homeostatic mechanisms for fluid balance during obstruction and relief.
Area of Science:
- Nephrology
- Endocrinology
- Urology
Background:
- Chronic bilateral ureteric obstruction due to high pressure chronic retention of urine (HPCR) significantly impacts renal and endocrine function.
- Understanding the hormonal milieu during obstruction and decompression is crucial for managing fluid and electrolyte balance.
Purpose of the Study:
- To investigate the dynamic changes in serum atrial natriuretic peptide (ANP), plasma renin activity (PRA), angiotensin II (AII), and aldosterone levels.
- To elucidate the role of these hormones in the physiological response to chronic obstruction and subsequent urinary tract decompression.
Main Methods:
- Prospective study involving patients with HPCR.
- Measurement of serum ANP, PRA, AII, and aldosterone levels during the obstructed state and post-decompression (urethral catheterization).
Main Results:
- Elevated serum ANP levels during obstruction decreased rapidly after catheterization, with a transient resurgence before stabilization.
- Plasma renin activity (PRA) was initially suppressed, then increased post-catheterization, lagging behind ANP changes.
- Angiotensin II (AII) and aldosterone levels showed a similar trend to PRA but remained partially elevated during obstruction.
Conclusions:
- Hormonal alterations, including ANP, PRA, AII, and aldosterone, reflect homeostatic responses to maintain sodium and water balance during HPCR.
- These mechanisms also play a role in limiting post-obstructive diuresis following urinary tract decompression.