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Low concentrations of intravenous polygelines promote low‐molecular weight proteinuria
Author(s) -
Veldman B. A. J.,
Schepkens H. L. E.,
Vervoort G.,
Klasen I.,
Wetzels J. F. M.
Publication year - 2003
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.2003.01258.x
Subject(s) - medicine , excretion , proteinuria , albuminuria , atrial natriuretic peptide , reabsorption , endocrinology , diuresis , renal function , kidney
Background Previously we observed that atrial natriuretic peptide (ANP)‐induced albuminuria was accompanied by an increase in urinary excretion of the low‐molecular weight protein (LMW protein) β 2 ‐microglobulin (β 2 ‐m), suggesting that the albuminuria may at least partly be the result of blockade of tubular protein reabsorption. However, in our experiments ANP was dissolved in the polygeline Haemaccel ® (Hoechst, Behring‐Werke, Marburg Germany) to prevent adhesion of ANP to the infusion system. Anecdotal reports have shown that high dosages of polygelines such as Haemaccel ® or Gelofusine ® (Braun NPBI Oss, the Netherlands) may influence tubular protein handling. In the present study we have evaluated the effect of a low and high doses of the polygeline Haemaccel ® on proteinuria. In addition, we have reassessed the effects of ANP. Materials and methods We measured urinary β 2 ‐microglobulin (β 2 ‐m) and albumin excretion in healthy volunteers after infusion of a high‐dose pure Haemaccel ® (0·04 mL kg −1 min −1 for 60 min), a low‐dose Haemaccel ® (0·01 mL kg −1 min −1 for 60 min followed by infusion of 0·02 mL kg −1 min −1 for 60 min) and a low‐dose Gelofusine ® (dose comparable to the low‐dose Haemaccel ® ). In addition we performed similar studies using ANP dissolved in saline and Haemaccel ® . Results Infusion of Haemaccel ® caused a dose‐dependent increase in urinary excretion of β 2 ‐m. There were no differences between Haemaccel ® and Gelofusine ® . After infusion of ANP dissolved in Haemaccel ® urinary β 2 ‐m excretion increased from 0·05 ± 0·03 µg min −1 to 27 ± 10 µg min −1 and urinary albumin excretion increased from 4·5 ± 1·1 µg min −1 to 9·7 ± 6·3 µg min −1 ( P < 0·05). During ANP + saline infusion, urinary β 2 ‐m excretion did not change, whereas the urinary albumin excretion increased from 5·3 ± 1·5 µg min −1 to 7·9 ± 2·4 µg min −1 ( P < 0·05). Conclusions Our study demonstrates that even low doses of the polygelines Haemaccel ® and Gelofusine ® profoundly attenuate the tubular reabsorption of the low‐molecular weight protein β 2 ‐m. Atrial natriuretic peptide does not affect tubular protein reabsorption. Therefore, the rise in albuminuria during ANP infusion most likely reflects alterations in glomerular permeability.