This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pedrinelli, R. Articles by Salvetti, A. Search for Related Content PubMed PubMed Citation Articles by Pedrinelli, R. Articles by Salvetti, A.

Hypertension, Vol 14, 156-163, Copyright © 1989 by American Heart Association

ARTICLES

Low dose atrial natriuretic factor in primary aldosteronism: renal, hemodynamic, and vascular effects

R Pedrinelli, G Panarace, M Spessot, S Taddei, S Favilla, L Graziadei, A Lucarini and A Salvetti
Hypertension Unit, I Clinica Medica, University of Pisa, Italy.

Whether atrial natriuretic factor (ANF) plays a physiological role in primary aldosteronism has yet to be determined. In the present study, the renal, hemodynamic, humoral, and vascular effects of a synthetic (WY-47663) human analogue were studied in five water-loaded (15 ml H2O/kg) patients with adenomatous primary aldosteronism, a salt- sensitive, low renin, volume-expanded syndrome. ANF was infused for 3 hours at a low rate (0.005 micrograms/kg/min), which approximately doubled circulating immunoreactive ANF. Glomerular filtration rate and renal blood flow (inulin and para-aminohippurate clearance) remained stable, but sodium excretion increased significantly suggesting a dissociation between renal hemodynamics and natriuresis as well as a direct inhibitory effect on tubular sodium reabsorption by ANF. Intra- arterial diastolic blood pressure, heart rate, forearm blood flow (plethysmographic method), and arterial plasma norepinephrine did not change, but systolic blood pressure declined and hematocrit rose suggesting plasma volume contraction by ANF. Plasma aldosterone levels were unchanged indicating a loss of ANF-mediated aldosterone inhibition, possibly related to qualitative or quantitative alterations of ANF receptors in tumoral adrenal tissue. Infusion of the analogue into the brachial artery was at a rate of 0.005 micrograms/dl forearm tissue/min x 30 minutes, which also doubled local immunoreactive venous ANF concentrations and vasodilated forearm arterioles. These data suggest a physiological role for ANF in modulating body fluid volume even in human primary aldosteronism.

This article has been cited by other articles:

				G. Dell'Omo, L. Ferrini, M. Morale, F. De Negri, E. Melillo, F. Carmassi, and R. Pedrinelli Acetylcholine-Mediated Vasodilatation and Tissue-type Plasminogen Activator Release in Normal and Hypertensive Men Angiology, April 1, 1999; 50(4): 273 - 282. [Abstract] [PDF]