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      Effects of Hemodialysis on Circulating Adrenomedullin Concentrations in Patients with End-Stage Renal Disease

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          To characterize the determinants of circulating levels of adrenomedullin (AM), the plasma levels of this peptide were measured in 58 patients with end-stage renal disease on hemodialysis. Predialysis plasma levels of AM were more than twice as high in patients on hemodialysis as compared to controls. In hemodialysis patients with heart failure (NYHA classes II–IV) or hypertensive HD patients plasma levels of AM were significantly higher than in patients with end-stage renal disease only. Plasma levels of AM were not altered immediately by hemodialysis but decreased significantly 14–20 h after hemodialysis. AM plasma levels before hemodialysis and 14–20 h after hemodialysis were correlated with the corresponding mean arterial pressure.

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          Hemodynamic effects of a novel hypotensive peptide, human adrenomedullin, in rats.

          The hemodynamic effects of human adrenomedullin were investigated in anesthetized Wistar rats. Intravenous administration of adrenomedullin (1.0 nmol/kg) caused a rapid and marked reduction in mean blood pressure associated with a decrease in total peripheral resistance. This reduction in mean blood pressure was closely correlated with the decrease in total peripheral resistance. These findings indicate that human adrenomedullin is a potent vasodilator and may have some role in the regulation of blood pressure.
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            Immunoreactive adrenomedullin in human plasma.

            A specific and sensitive radioimmunoassay for adrenomedullin has been developed. Half-maximal inhibition of binding of radioiodinated adrenomedullin was observed at 4 fmol/tube. The radioimmunoassay recognized the entire adrenomedullin molecule and has little crossreactivity with adrenomedullin fragment peptides. Adrenomedullin-like immunoreactivity was found to circulate in human plasma at considerable concentration (3.3 +/- 0.39 fmol/ml). The immunoreactivity of adrenomedullin was eluted at almost the same position as synthetic adrenomedullin on gel-filtration chromatography and reverse-phase high-performance liquid chromatography, suggesting that circulating adrenomedullin recognized by the present radioimmunoassay is identical or very similar to authentic adrenomedullin. Plasma immunoreactive adrenomedullin significantly increased in patients with hypertension, with a progressive rise proportionate to disease severity.

              Author and article information

              Blood Purif
              Blood Purification
              S. Karger AG
              October 1998
              29 January 1999
              : 16
              : 5
              : 269-274
              Departments of a Nephrology, b Clinical Pharmacology, and c Cardiology, Medizinische Klinik, Klinikum Innenstadt Ludwig Maximillians University, Munich, Germany
              14344 Blood Purif 1998;16:269–274
              © 1998 S. Karger AG, Basel

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              Page count
              Figures: 3, Tables: 2, References: 16, Pages: 6
              Self URI (application/pdf):
              Original Paper

              Cardiovascular Medicine, Nephrology

              Adrenomedullin, End-stage renal disease, Hemodialysis


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