RAISED PLASMA ENDOTHELIN-1 CONCENTRATION IN PATIENTS WITH NEPHROPATHIA-EPIDEMICA

Nephropathia epidemica (NE) with renal syndrome, caused by the Puumala -virus, is manifested clinically by the triad of fever, hemorrhage and renal failure. We observed raised plasma concentrations of endothelin -1 (ET-1) and atrial natriuretic peptide (ANP) in 23 patients during t he acute phase of NE. They all developed transient renal failure and a ll displayed characteristics of NE, also verified by a rapid IgG antib ody test. Blood pressure was normal or low in all subjects during the acute phase of the disease. Plasma ET-1 and ANP levels returned to nor mal following recovery one month later. The cause of increased ET-1 sy nthesis in NE remains unknown. It may be related to vascular damage or extravasation of blood. ET-1 may participate in the pathogenesis of a cute renal failure of NE. Raised plasma ANP levels were most likely ca used by fluid retention during the acute phase of NE. However, high le vels of circulating ET-1 might have contributed to increased release o f ANP.