[Changes in the level of plasma atrial natriuretic factor in patients with chronic renal failure]

Changes of plasma atrial natriuretic factor (ANF) levels in 89 patients with different kinds of renal diseases (including 39 patients treated with hemodialysis) were studied. The results showed: 1. The mean value of plasma ANF level was significantly increased in patients with renal diseases than that in healthy subjects. The increase was positively correlated with the change of creatinine, serum potassium, mean arterial pressure and ptfV1. The plasma ANF level was markedly decreased after hemodialysis. 2. The right atrial pressure of 8 patients with chronic renal failure measured by right heart catheterization was normal. No significant changes occurred after hemodialysis. 3. Impedance cardiogram and mechanical cardiogram showed that left heart function was significantly improved after hemodialysis. 4. ANF was detected in ultrafiltration liquid. 5. There was no difference of the ANF content between the serum of the first and maintenance hemodialysis. The authors thought that the main causes of increase of plasma ANF level are decrease of catabolic metabolism in renal failure, stimulation of ANF secretion by left heart failure and increased loading of left atrium and increased production of ANF by body compensation as the result of mean arterial pressure increase. The decrease of ANF after hemodialysis was mainly due to improvement of renal and cardiac function, lessening of the left atrial loading, the reduced mean arterial pressure and its direct elimination by hemodialysis.