ATRIAL-NATRIURETIC-PEPTIDE (ANP) IN ACUTE-RENAL-FAILURE

In animal studies it is shown that ischemic and toxic acute renal failure (ARF) are ameliorated by ANP. Therefore we investigated the effect of ANP in critically ill patients with protracted ARF. 13 patients (9 men, 4 women) with acute intrinsic renal failure were investigated. 4 patients were anuric, 3 patients oliguric and 6 patients non-oliguric. ANP (1-28 hAnaP, 0,05-mu-g/kg BW/min) was infused for 3 h. Following parameters were measured: serum creatinine, electrolytes, osmolality, plasma catecholamines, plasma renin activity and glomerular filtration rate (GFR, Cr-EDTA) before and after ANP-infusion. ANP was not able to reverse anuria, in non-oliguric patients urine volume increased slightly. GFR did not change significantly in the anuric group and in the non-oliguric group, respectively. Sodium excretion (FENa) increased by about 40% in non-oliguric patients. These data suggest that ANP was not able to ameliorate acute intrinsic renal failure.