ATRIAL-NATRIURETIC-PEPTIDE AND CYCLIC GUANOSINE-MONOPHOSPHATE IN CHILDREN AND ADOLESCENTS ON PERITONEAL-DIALYSIS

Plasma concentrations of atrial natriuretic peptide (ANP) and its seco nd messenger cyclic guanosine-monophosphate (cGMP) were studied in 28 children and adolescents (1 to 19 years) on peritoneal dialysis and co mpared to 55 healthy children (1 to 20 years). Dialysate concentration s of the hormones were measured also in the patients. Plasma ANP was n ot significantly different in patients and controls (28.8 pmol/l [15.5 -53.6 pmol/l] [median, lower and upper quartile] versus 26.3 pmol/l [1 9.9-31.8 pmol/l]). In seven children on peritoneal dialysis it exceede d an upper normal limit of 50 pmol/l, but it fell to normal values in four of them after forced fluid withdrawal. Plasma cGMP was elevated i n the patients compared to the control children (1.6 nmol/l [1.1-1.7 n mol/l] versus 1.0 nmol/l [0.8-1.2 nmol/l]; p <0.05). There were only w eak correlations between plasma and dialysate concentrations of ANP an d cGMP. Plasma concentrations of ANP seem to be elevated in children o n peritoneal dialysis in case of fluid overload.