ADRENOMEDULLIN AND PROADRENOMEDULLIN N-TERMINAL-20 PEPTIDE IN IMPAIRED RENAL-FUNCTION

Proadrenomedullin N-terminal 20 peptide (PAMP) is a novel hypotensive peptide found in the N-terminal portion of the prohormone of adrenomed ullin (AM), a vasodilator peptide. In this study, we examined the path ophysiolog,ical roles of the two peptides. Plasma concentrations of bo th peptides in patients with impaired renal function were measured and compared to those of the control subjects. Plasma AM concentrations i n the study patients were significantly (P < 0.01) higher than in the controls with a serum creatinine of <1 mg/dl (2.94 +/- 0.18 fmol/ml), and higher concentrations in those patients with a serum creatinine of greater than or equal to 2 mg/dl (Group II; 14.8 +/- 1.9 fmol/ml) wer e observed as compared to those at the 1 to 2 mg/dl level (Group I; 10 .3 +/- 1.2 fmol/ml). Similarly, plasma PAMP concentrations tended to b e higher in the Group I patients (0.82 +/- 0.05 fmol/ml) and significa ntly (P < 0.01) increased in the Group II patients (1.42 +/- 0.17 fmol /ml) when compared to the controls (0.53 +/- 0.04 fmol/ml). A signific antly (P < 0.05) positive correlation was noted between the plasma AM and PAMP in the study patients. These findings suggest a potential rol e for these biologically active peptides in the regulation of blood pr essure in impaired renal function.