PLASMA-CONCENTRATIONS OF NATRIURETIC PEPTIDES IN PATIENTS ON HEMODIALYSIS

The usefulness of plasma atrial natriuretic peptide (ANP), brain natri uretic peptide (BNP), C-type natriuretic peptide (CNP), and cyclic gua nosine 3',5'-monophosphate (cGMP) as markers of fluid overload was exa mined in hemodialysis (HD) patients without diabetes mellitus. Plasma concentrations of ANP, BNP, CNP, and cGMP all decreased significantly during HD. Before HD, there was a strong correlation between plasma co ncentrations of ANP and those of BNP, and plasma concentrations of cGM P correlated significantly with those of all three natriuretic peptide s. The cardiothoracic ratio also correlated significantly with plasma concentrations of ANP and those of BNP before HD. Systolic blood press ure correlated significantly only with plasma concentrations of CNP, b oth before and after HD. Changes in body weight during HD correlated o nly with those in plasma ANP; there was thus no correlation between ch anges in body weight and those in plasma CNP. In conclusion, only plas ma ANP is a useful marker of the proper volume and dry weight of HD pa tients. Furthermore, CNP may participate in cardiovascular regulation in HD patients in a manner different from those of ANP and BNP.