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1 Divisions of Nephrology, San Francisco General Hospital, University of California San Francisco, San Francisco, California 94143; and 2 University of Washington, Seattle, Washington 98195
Nephrotic syndrome is associated with resistance to the renal
actions of atrial natriuretic peptide (ANP). We performed experiments in anesthetized, acutely nephrectomized rats 21-28 days after injection of adriamycin (7-8 mg/kg iv) or 9-14 days after
injection of anti-Fx1A antiserum (5 ml/kg ip) (passive Heymann
nephritis; PHN) to test whether extrarenal resistance also occurred.
Proteinuria was significantly elevated in both models compared with
controls before study. ANP infusion (1 µg · kg
1 · min
1)
caused arterial pressure to decrease similarly in control rats, adriamycin-treated rats, and rats with PHN (by 8.2 ± 1.0, 9.4 ± 2.3, and 9.0 ± 2.0%, respectively; all
P < 0.05 vs. both baseline and
vehicle-infused control rats). In control rats, hematocrit increased
progressively to a maximal value 9.5 ± 0.9% over baseline as a
result of the infusion, an increase corresponding to a reduction in
plasma volume of 16.1 ± 0.9%. The ANP-induced increase in
hematocrit was preserved in adriamycin-treated rats (9.2 ± 1.3%)
but was markedly blunted in rats with PHN (2.4 ± 1.3%;
P < 0.0001 vs. ANP infusion in
control rats). ANP infusion increased plasma ANP levels to the same
extent in the three groups, whereas plasma guanosine
3',5'-cyclic monophosphate was significantly lower in rats
with PHN compared with both control and adriamycin-treated rats.
Infusion of a subpressor dose of angiotensin II (ANG II, 2.5 ng · kg
1 · min
1)
fully restored the ANP-induced increase in hematocrit in rats with PHN.
This study demonstrates that 1) the
hemoconcentrating and hypotensive actions of ANP are preserved in
adriamycin-treated rats, 2) the
effect of ANP on hematocrit and fluid distribution is blunted in rats
with PHN while its hypotensive action is preserved, and
3) low-level ANG II infusion
normalizes the hemoconcentrating effect of exogenously infused ANP in
rats with PHN. Thus deficient ANG II generation in rats with PHN, but
not adriamycin nephrosis, may contribute to extrarenal ANP resistance.
angiotensin II; arterial pressure; guanosine 3',5'-cyclic monophosphate; nephrectomized animals; nephrotic edema; plasma volume; proteinuria; renin-angiotensin system; vascular permeability
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