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Nephrol Dial Transplant (1993) 8: 711-715
© 1993 European Renal Association-European Dialysis and Transplant Association

research-article

Exaggerated natriuresis induced by sodium chloride infusion in essential hypertension is accompanied by an exaggerated urinary 3' 5' guanosine monophosphate excretion

K. Widecka1,, R. Celibala1, J. Gozdzik1, A. Syrenicz1, K. Ciechanowski2 and S. Czekalski1,2

1Departments of Endocrinology and Metabolic Diseases Szczecin, Poland 2Departments of Clinical Biochemistry and Laboratory Diagnostics, Pomeranian University School of Medicine Szczecin, Poland

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr Krystyna Widecka, Department of Endocnnology and Metabolic Diseases, Arkonska 4, 71–445 Szczecin, Poland.

The effects of an intravenous infusion of physiological saline on plasma atrial natriuretic peptide (ANP), guanosine 3' 5' monophosphate (cGMP) con centrations, and on urinary CGMP and sodium excre tion were studied in 13 patients with essential hypertension, class I according to WHO criteria, and in 10 healthy subjects. It was found that the groups did not differ as to basal and infusion-induced plasma ANP and cGMP and basal urinary cGMP and sodium excretion, but the sodium chloride infusion resulted in a significantly greater urinary cGMP and sodium excre tion and creatinine clearance in hypertensive than in control subjects.

The results of this study demonstrate that patients with essential hypertension respond to an intravenous sodium chloride load not only with exaggerated natri uresis, but also with augmented urinary CGMP excre tion. The latter finding may in part be due to a greater glomerular filtration of cGMP, but increased renal contribution cannot be excluded. Apart from the pos sible stronger intrarenal effect of ANP on cGMP production in patients with hypertension, independent direct effect of volume expansion on cGMP excretion and modified activity of other cGMP generating sys tems may all be responsible for the higher unnary cGMP excretion in essential hypertension.

Keywords: atrial natriuretic peptide; cyclic guanosine essential monophosphate; essential hypertension; urinary sodium excretion


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