The role of atrial natriuretic peptide (ANP) in chronic liver disease

Dedicated to Professor Dr. G. Paumgartner on the occasion of his 60th birthday.
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Abstract

The role of atrial natriuretic peptide (ANP) and potential defects of ANP in liver disease are reviewed. Patients with cirrhosis of the liver show no decrease of ANP plasma concentrations nor changes in the pattern of ANP immunoreactivity nor changes of splanchnic ANP clearance. The renal effects of exogenously administered as well as endogenously released ANP are blunted in cirrhosis, in particular in patients with ascites. This seems due to increased activity of sodium-retaining hormonal systems and changes of the renal ANP receptor status. Pharmacological inhibition of ANP-degradation or clearance may yield therapeutic potential.

References (83)

  • P. Larose et al.

    Radioimmunoassay of atrial natriuretic factor: human plasma levels

    Biochem. biophys. Res. Commun.

    (1985)
  • K. Lenz et al.

    Ornipressin in the treatment of functional renal failure in compensated liver cirrhosis. Effects on renal hemodynamics and atrial natriuretic factor

    Gastroenterology

    (1991)
  • C. López et al.

    Role of altered systemic hemodynamics in the blunted renal response to atrial natriuretic peptide in rats with cirrhosis and ascites

    J. Hepatol.

    (1989)
  • R. Moreau et al.

    Clearance of atrial natriuretic peptide in patients with cirrhosis. Role of liver failure

    J. Hepatol.

    (1991)
  • T.R. Morgan et al.

    Atrial natriuretic factor in experimental cirrhosis in rats

    Gastroenterology

    (1992)
  • R. Naccarato et al.

    Renal handling of sodium and water in early chronic liver disease

    Gastroenterology

    (1981)
  • B.G. Nair et al.

    Increase in the number of atrial natriuretic hormone receptors in regenerating rat liver

    J. biol. Chem.

    (1991)
  • W.G. Rector et al.

    Atrial volume in cirrhosis: relationship to blood volume and plasma concentration of atrial natriuretic factor

    Gastroenterology

    (1990)
  • F. Salerno et al.

    Atrial natriuretic factor in cirrhotic patients with tense ascites

    Gastroenterology

    (1990)
  • F. Trevisani et al.

    Circadian variation in renal sodium and potassium handling in cirrhosis

    Gastroenterology

    (1989)
  • F.A. Almeida et al.

    Clearance function of type C receptors of atrial natriuretic factor in rats

    Am. J. Physiol.

    (1989)
  • P. Angeli et al.

    Variability of atrial natriuretic peptide plasma levels in ascitic cirrhotics: pathophysiological and clinical implications

    Hepatology

    (1992)
  • R.M. Arendt et al.

    Molecular weight heterogeneity of plasma-ANF in cardiovascular disease

    Klin. Wochenschr.

    (1986)
  • R.M. Arendt et al.

    Differential processing of plasma-ANF in cardiovascular disease

  • S. Badalamenti et al.

    Renal effects in cirrhotic patients with avid sodium retention of atrial natriuretic factor injection during norepinephrine infusion

    Hepatology

    (1992)
  • B.J. Ballermann et al.

    Physiologic regulation of atrial natriuretic factor receptors in rat renal glomeruli

    J. clin. Invest.

    (1985)
  • F. Bendtsen et al.

    Azygos, hepatic, renal and peripheral extraction of atrial natriuretic factor (ANF) in patients with cirrhosis. Effect of beta-adrenergic blockade

    Scand. J. clin. Lab. Invest.

    (1993)
  • M. Bernardi et al.

    The hemodynamic status of preascitic cirrhosis: an evaluation under steady-state conditions and after postural change

    Hepatology

    (1992)
  • M. Bernardi et al.

    Renal sodium retention during upright posture in pre-ascitic cirrhosis

    Gastroenterology

    (1993)
  • J.J. Beutler et al.

    Blunted natriuretic response and low blood pressure after atrial natriuretic factor in early cirrhosis

    Hepatology

    (1989)
  • V.M. Buckalew et al.

    Natriuretic hormone

  • V. Cachofeiro et al.

    Glomerular and vascular atrial natriuretic factor receptors in adrenalectomized rats

    Am. J. Physiol.

    (1989)
  • M. Cantin et al.

    The heart as an endocrine gland

    Sci. Am.

    (1986)
  • M. Chinkers et al.

    A membrane form of guanylate cyclase is an atrial natriuretic peptide receptor

    Nature (Lond.)

    (1989)
  • H.E. De Wardener et al.

    Concept of natriuretic hormone

    Physiol. Rev.

    (1985)
  • J.-C. Dussaule et al.

    Effect of sinorphan, an enkephalinase inhibitor, on plasma atrial natriuretic factor and sodium urinary excretion in cirrhotic patients with ascites

    J. clin. Endocr. Metab.

    (1991)
  • M. Epstein

    Natriuretic hormone and the sodium retention of cirrhosis

    Gastroenterology

    (1981)
  • M. Epstein

    Atrial natriuretic factor in patients with liver disease

    Am. J. Nephrol.

    (1989)
  • L.J. Field et al.

    Kidney function in ANF-transgenic mice: effect of blood volume expression

    Am. J. Physiol.

    (1991)
  • J.D. Firth et al.

    Low concentrations of ANP cause pressure-dependent natriuresis in the isolated kidney

    Am. J. Physiol.

    (1988)
  • A.L. Gerbes

    Pathophysiology of ascites formation in cirrhosis of the liver

    Hepato-Gastroenterology

    (1991)
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