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

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          Abstract

          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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          Most cited references 2

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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.
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              Author and article information

              Journal
              BPU
              Blood Purif
              10.1159/issn.0253-5068
              Blood Purification
              S. Karger AG
              0253-5068
              1421-9735
              1998
              October 1998
              29 January 1999
              : 16
              : 5
              : 269-274
              Affiliations
              Departments of a Nephrology, b Clinical Pharmacology, and c Cardiology, Medizinische Klinik, Klinikum Innenstadt Ludwig Maximillians University, Munich, Germany
              Article
              14344 Blood Purif 1998;16:269–274
              10.1159/000014344
              9917535
              © 1998 S. Karger AG, Basel

              Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

              Page count
              Figures: 3, Tables: 2, References: 16, Pages: 6
              Product
              Self URI (application/pdf): https://www.karger.com/Article/Pdf/14344
              Categories
              Original Paper

              Cardiovascular Medicine, Nephrology

              Adrenomedullin, End-stage renal disease, Hemodialysis

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