ATRIAL-NATRIURETIC-PEPTIDE AND RENAL ADAPTATION TO CONTRALATERAL NEPHRECTOMY IN HEALTHY MAN

Atrial natriuretic peptide (ANP), angiotensin II (AII), aldosterone (Aldo) and arginine vasopression (AVP) in plasma were determined in 12 healthy renal transplant donors before and 5, 12, 26, 54 days after uninephrectomy (Nx) in order to study the possible role of these hormones in functional adaptation to acute reduction in renal mass. Glomerular and tubular function was studied by measurements of the clearances of 51Cr-EDTA, lithium, sodium, postassium, and albumin. ANP was 7.4+/-3.1 pmol 1-1 (mean+/-SD) before Nx and 8.7+/-6.1 pmol 1-1 at 5 days after Nx and remained at this level through the observation period. Aldo showed a non-significant transient fall at 5 days after Nx. AII and AVP remained normal after Nx. At 5 days after Nx glomerular filtration rate (GFR) of the remaining kidney had risen from 45+/-7 ml min-1 before Nx to 57+/-8 ml min-1 (p < 0.01), lithium clearance had risen from 13+/-2 ml min-1 before Nx to 20+/-7 ml min-1 (p < 0.01), and sodium and water balance was normal. To conclude, plasma ANP, AII, Aldo and AVP do not appear to be responsible for the hyperfiltration and depression of fractional proximal sodium and water reabsorption observed in recently uninephrectomized man with normal sodium and water balance.