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Atrial natriuretic factor, cyclic 3‘,5’‐guanosine monophosphate and prostaglandin E 2 in liver cirrhosis: relation to blood volume and changes in blood volume after furosemide
Author(s) -
JESPERSEN B.,
JENSEN L.,
SØRENSEN S. S.,
PEDERSEN E. B.
Publication year - 1990
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 - 10.1111/j.1365-2362.1990.tb01912.x
Subject(s) - medicine , endocrinology , furosemide , cirrhosis , aldosterone , ascites , vasopressin , plasma renin activity , cyclic guanosine monophosphate , atrial natriuretic peptide , chemistry , renin–angiotensin system , nitric oxide , blood pressure
. Plasma concentrations of atrial natriuretic factor (ANF) and cyclic 3′,5‐guanosine monophosphate (cGMP) were measured in 11 cirrhotic patients with ascites, 11 cirrhotic patients without ascites and 15 control subjects. The following were determined in 15 of the cirrhotic patients and in all the control subjects: blood volume (BV) and furosemide‐induced changes in BV, plasma values of ANF, cGMP, angiotensin II (AII), aldosterone (Aldo), arginine vasopressin (AVP) and urinary excretion rates of cGMP, prostaglandin E 2 (PGE 2 ), water and sodium. Basal plasma levels of ANF and cGMP were higher in patients with cirrhosis than in controls, but were the same in both groups of cirrhotics (ANF: cirrhosis with ascites 12.7, without ascites 13.4, and in controls 5.8 pmol l ‐1 (medians); cGMP: 7.7, 7.4 and 4.3 nmol l ‐1 , respectively). BV was less reduced after furosemide in the cirrhotic patients (6.0%) than in the healthy subjects (10.1%), but basal BV did not differ. Urinary sodium excretion rates after furosemide were significantly lower in the cirrhotic patients than in the controls. PGEl excretion rate increased after furosemide in the cirrhotic patients (0.29 to 0.66 pmol minl ‐1 ; P < 0.01) but not in the controls (0.31 to 0.38 pmol minl ‐1 ). After furosemide ANF and cGMP decreased slightly in both groups whereas AII and Aldo increased; AVP increased in the controls, but not in the cirrhotic patients. In conclusion, plasma values of ANF and cGMP are increased in liver cirrhosis both with and without ascites. This and the elevated PGEl 2 excretion after furosemide may be compensatory phenomena in order to facilitate renal sodium excretion.