INCREASED RELEASE OF KALIURETIC PEPTIDE DURING IMMERSION-INDUCED CENTRAL HYPERVOLEMIA IN CIRRHOTIC HUMANS

Kaliuretic peptide is a recently discovered potent stimulator of potas sium and water excretion. Its role in modulating renal water handling in cirrhotic patients has not been defined. The responses of circulati ng kaliuretic peptide and atrial natriuretic factor in 8 cirrhotic sub jects to water immersion were significantly greater (p < 0.05) than th ose of 7 healthy volunteers. With cessation of immersion, atrial natri uretic factor decreased within 30 min to preimmersion values, whereas kaliuretic peptide remained significantly elevated >1 h, suggesting a slower clearance for kaliuretic peptide. The peak diuretic response to immersion corresponded in a temporal fashion to the peak circulating concentration of kaliuretic peptide, suggesting a possible physiologic al role of kaliuretic peptide in modulating volume homeostasis in cirr hotic humans.