PLASMA-CONCENTRATION OF HUMAN ADRENOMEDULLIN IN PATIENTS ON HEMODIALYSIS

To investigate a possible pathophysiological role of human adrenomedul lin (AM), we measured the plasma concentration of immunoreactive-AM (i r-AM) in 38 patients with end-stage renal disease (ESRD) on hemodialys is (HD) and 38 healthy subjects (age and sex matched), In addition, pl asma ir-AM was characterized by a reverse-phase high performance liqui d chromatography. The mean value (+/- SEM) of plasma AM in the patient s before HD (10.1 +/- 0.67 fmol/ml) was markedly higher than that in t he control group (2.9 +/- 0.13 fmol/ml, p <0.001), but plasma AM level s were not altered by HD. There was a significant correlation between plasma AM levels and mean blood pressure (MBP) in a group of subjects including both patients before HD and healthy subjects (p <0.01). In c hromatographic study, the major peak of ir-AM in the plasma from patie nts on HD, as well as healthy subjects, emerged at an elution time ide ntical to that of synthetic AM, indicating that the active form of AM was present in the circulating blood. The secretion of AM seemed to be increased in response to the conditions elicited by ESRD such as hype rvolemia and/or hypertension, and reduced renal excretion of the pepti de may also contribute to its high plasma level.