Plasma and urine levels of adrenomedullin and proadrenomedullin N-terminal20 peptide in chronic glomerulonephritis

Proadrenomedullin N-terminal 20 peptide (PAMP) is a novel hypotensive pepti de present in the precursor of adrenomedullin (AM), a vasodilative and natr iuretic peptide. We examined the plasma and urinary levels of these peptide s in patients with chronic glomerulonephritis (CGN). The mean plasma AM con centration of the patients with CGN did not differ from that of control sub jects (4.17 +/- 0.17 v 3.87 +/- 0.21 fmof/ml, respectively), whereas urinar y AM excretion was significantly less in the patients with CGM (5.96 +/- 0. 95 v control, 8.93 +/- 1.02 fmol/mg of creatinine; P < 0.05). Plasma concen trations and urinary excretion of PAMP were significantly less for the pati ents with CGN compared with control subjects (0.91 +/- 0.08 v 1.23 +/- 0.20 fmol/mL; P < 0.05 and 25.0 +/- 3.0 v 35.0 +/- 3.6 fmol/mg of creatinine, r espectively; P < 0.05). The plasma AM concentration was negatively correlat ed with plasma renin activity (r = -0.58; P < 0.01) and aldosterone concent ration (r = -0.40; P < 0.05), Urinary excretions of AM and PAMP showed sign ificant correlations with urine excretion of sodium (r = 0.39; P < 0.05 and r = 0.49; P < 0.01, respectively). These findings suggest that AM and PAMP may have roles in the regulation of sodium in patients with CGN. (C) 1999 by the National Kidney Foundation, Inc.