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      Influence of the Renin-Angiotensin System and Atrial Natriuretic Peptide on Renal Functional Reserve

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          Abstract

          We studied the renin-angiotensin system (RAS) and atrial natriuretic peptide (ANP) after amino acid loading in order to elucidate whether or not glomerular hyperfiltration is mediated by these hormones. Eight healthy controls without kidney disease (grop 1), 8 renal graft recipients (group 2) and 8 patients after nephrectomy (group 3) werde studied. Furthermore, we investigated the influence of amino acid loading on RAS and ANP and glomerular filtration during acute application of captopril in healthy controls. Clearances in inulin (C<sub>In</sub>) and para-aminohippuric acid (C<sub>PAH</sub>) werde determined during an infusion of 0.9% saline and during amino acid loading. C<sub>In</sub> increased in healthy controls from 96.5 ± 3.3 to 111.9 ± 4.4 ml/min (p < 0.01), C<sub>PAH</sub> rose from 577 ± 28.7 to 618.9 ± 38 ml/min (p = NS). During the combined application of amino acid infusion and 25 mg captopril, C<sub>IN</sub> increased to 125.0 ± 16.4 ml/min/1.73 m<sup>2</sup> (p < 0.01) and there was no significant increase in C<sub>PAH</sub> which was 595 ± 77 ml/min/1.73 m<sup>2</sup>. There was no significant change in renal vascular resistance, but filtration fraction increased from 17 ± 1 to 19 ± 1% under amino acid infusion and increased further under the application of captopril to 21 ± 2% (p < 0.05). In renal graft recipients, C<sub>In</sub> had a tendency to increase during amino acid infusion from 78.4 ± 5.8 to 84.7 ± 6.5 ml/min (p = NS). In patients after nephrectomy, C<sub>In</sub> did not increase (84.5 ± 6 ml/min) but C<sub>PAH</sub> did from 345.7 ± 26.3 to 409 ± 24.1 ml/min (p < 0.05). In healthy controls, ANP was not increased during amino acid infusion: 80.5 ± 9.3 pg/ml as compared to saline infusion with 62.0 ± 10.6 pg/ml (p = NS). During the administration of amino acid infusion in renal graft recipients, ANP was not increased: 283 ± 62.7 as compared to 334 ± 115.7 pg/ml under saline infusion. A renal functional reserve could be shown in healthy persons, but this was grossly diminished in graft recipients and patients after unilateral nephrectomy. Renal functional reserve was maintained in healthy controls during the application of captopril. This investigation indicates that the increase in glomerular filtration rate seen in healthy persons is not mediated by RAS or ANP.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1994
          1994
          16 December 2008
          : 66
          : 1
          : 14-20
          Affiliations
          Department of Nephrology, Heinrich Heine University, Düsseldorf, FRG
          Article
          187760 Nephron 1994;66:14–20
          10.1159/000187760
          8107949
          © 1994 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
          Pages: 7
          Categories
          Original Paper

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