Cardiorenal effects of atrial natriuretic factor administration in congestive heart failure

Natriuresis and diuresis without hemodynamic alterations

B. G. Firth, R. Perna, J. F. Bellomo, R. D. Toto

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Abstract

The effects of low bolus dose (70 ± 6 μg [mean ± SEM]) atrial natriuretic factor (ANF) administration was assessed in 16 patients with chronic congestive heart failure. Measurements were made for at least 60 minutes before and after the dose of ANF. There was a significant increase in urine flow rate (0.81 ± 0.06 to 1.81 ± 0.23 ml/min, p<0.01), sodium excretion rate (56 ± 14 to 80 ± 23 μEq/min, p<0.01), fractional excretion of sodium (1.23 ± 0.49 to 1.63 ± 0.60 percent, p<0.01) and potassium excretion rate (35±7 to 42±6 μEq/min, p<0.02). However, no significant alterations in renal plasma flow or glomerular filtration rate were observed. Furthermore, there was no significant correlation between the change in urine flow rate or sodium excretion rate and the change in renal plasma flow or glomerular filtration rate, respectively. In addition, there was no significant effect on cardiac index, mean aortic or left ventricular filling pressures, or systemic vascular resistance. There also was no discernible relationship between the response to ANF and the baseline concentrations of plasma ANF, aldosterone, or plasma renin activity. Thus, in patients with congestive heart failure, low dose ANF boluses may produce an increase in urine flow rate and sodium excretion rate that is independent of renal plasma flow or glomerular filtration rate. This suggests a meaningful direct renal tubular effect of exogenous ANF in this setting.

Original languageEnglish (US)
Pages (from-to)203-208
Number of pages6
JournalAmerican Journal of the Medical Sciences
Volume297
Issue number4
StatePublished - 1989

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Natriuresis
Diuresis
Atrial Natriuretic Factor
Heart Failure
Hemodynamics
Renal Plasma Flow
Sodium
Glomerular Filtration Rate
Urine
Ventricular Pressure
Aldosterone
Renin
Vascular Resistance
Potassium
Kidney

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Cardiorenal effects of atrial natriuretic factor administration in congestive heart failure: Natriuresis and diuresis without hemodynamic alterations",
abstract = "The effects of low bolus dose (70 ± 6 μg [mean ± SEM]) atrial natriuretic factor (ANF) administration was assessed in 16 patients with chronic congestive heart failure. Measurements were made for at least 60 minutes before and after the dose of ANF. There was a significant increase in urine flow rate (0.81 ± 0.06 to 1.81 ± 0.23 ml/min, p<0.01), sodium excretion rate (56 ± 14 to 80 ± 23 μEq/min, p<0.01), fractional excretion of sodium (1.23 ± 0.49 to 1.63 ± 0.60 percent, p<0.01) and potassium excretion rate (35±7 to 42±6 μEq/min, p<0.02). However, no significant alterations in renal plasma flow or glomerular filtration rate were observed. Furthermore, there was no significant correlation between the change in urine flow rate or sodium excretion rate and the change in renal plasma flow or glomerular filtration rate, respectively. In addition, there was no significant effect on cardiac index, mean aortic or left ventricular filling pressures, or systemic vascular resistance. There also was no discernible relationship between the response to ANF and the baseline concentrations of plasma ANF, aldosterone, or plasma renin activity. Thus, in patients with congestive heart failure, low dose ANF boluses may produce an increase in urine flow rate and sodium excretion rate that is independent of renal plasma flow or glomerular filtration rate. This suggests a meaningful direct renal tubular effect of exogenous ANF in this setting.",
author = "Firth, {B. G.} and R. Perna and Bellomo, {J. F.} and Toto, {R. D.}",
year = "1989",
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T1 - Cardiorenal effects of atrial natriuretic factor administration in congestive heart failure

T2 - Natriuresis and diuresis without hemodynamic alterations

AU - Firth, B. G.

AU - Perna, R.

AU - Bellomo, J. F.

AU - Toto, R. D.

PY - 1989

Y1 - 1989

N2 - The effects of low bolus dose (70 ± 6 μg [mean ± SEM]) atrial natriuretic factor (ANF) administration was assessed in 16 patients with chronic congestive heart failure. Measurements were made for at least 60 minutes before and after the dose of ANF. There was a significant increase in urine flow rate (0.81 ± 0.06 to 1.81 ± 0.23 ml/min, p<0.01), sodium excretion rate (56 ± 14 to 80 ± 23 μEq/min, p<0.01), fractional excretion of sodium (1.23 ± 0.49 to 1.63 ± 0.60 percent, p<0.01) and potassium excretion rate (35±7 to 42±6 μEq/min, p<0.02). However, no significant alterations in renal plasma flow or glomerular filtration rate were observed. Furthermore, there was no significant correlation between the change in urine flow rate or sodium excretion rate and the change in renal plasma flow or glomerular filtration rate, respectively. In addition, there was no significant effect on cardiac index, mean aortic or left ventricular filling pressures, or systemic vascular resistance. There also was no discernible relationship between the response to ANF and the baseline concentrations of plasma ANF, aldosterone, or plasma renin activity. Thus, in patients with congestive heart failure, low dose ANF boluses may produce an increase in urine flow rate and sodium excretion rate that is independent of renal plasma flow or glomerular filtration rate. This suggests a meaningful direct renal tubular effect of exogenous ANF in this setting.

AB - The effects of low bolus dose (70 ± 6 μg [mean ± SEM]) atrial natriuretic factor (ANF) administration was assessed in 16 patients with chronic congestive heart failure. Measurements were made for at least 60 minutes before and after the dose of ANF. There was a significant increase in urine flow rate (0.81 ± 0.06 to 1.81 ± 0.23 ml/min, p<0.01), sodium excretion rate (56 ± 14 to 80 ± 23 μEq/min, p<0.01), fractional excretion of sodium (1.23 ± 0.49 to 1.63 ± 0.60 percent, p<0.01) and potassium excretion rate (35±7 to 42±6 μEq/min, p<0.02). However, no significant alterations in renal plasma flow or glomerular filtration rate were observed. Furthermore, there was no significant correlation between the change in urine flow rate or sodium excretion rate and the change in renal plasma flow or glomerular filtration rate, respectively. In addition, there was no significant effect on cardiac index, mean aortic or left ventricular filling pressures, or systemic vascular resistance. There also was no discernible relationship between the response to ANF and the baseline concentrations of plasma ANF, aldosterone, or plasma renin activity. Thus, in patients with congestive heart failure, low dose ANF boluses may produce an increase in urine flow rate and sodium excretion rate that is independent of renal plasma flow or glomerular filtration rate. This suggests a meaningful direct renal tubular effect of exogenous ANF in this setting.

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