Plasma levels of brain natriuretic peptide in patients with cirrhosis

Authors

  • Giorgio La Villa M.D.,

    Corresponding author
    1. Istituto di Clinica Medica II, Unitá di Endocrinologia, University of Florence School of Medicine, I-50134 Florence, Italy
    • Clinica Medica II, University of Florence School of Medicine, viale Morgagni 85, I-50134 Florence, Italy
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  • Roberto Giulio Romanelli,

    1. Istituto di Clinica Medica II, Unitá di Endocrinologia, University of Florence School of Medicine, I-50134 Florence, Italy
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  • Vincenzo Casini Raggi,

    1. Istituto di Clinica Medica II, Unitá di Endocrinologia, University of Florence School of Medicine, I-50134 Florence, Italy
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  • Cristina Tosti-Guerra,

    1. Istituto di Clinica Medica II, Unitá di Endocrinologia, University of Florence School of Medicine, I-50134 Florence, Italy
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  • Maria Laura De Feo,

    1. Dipartimento di Fisiopatologia Clinica, Unitá di Endocrinologia, University of Florence School of Medicine, I-50134 Florence, Italy
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  • Fabio Marra,

    1. Istituto di Clinica Medica II, Unitá di Endocrinologia, University of Florence School of Medicine, I-50134 Florence, Italy
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  • Giacomo Laffi,

    1. Istituto di Clinica Medica II, Unitá di Endocrinologia, University of Florence School of Medicine, I-50134 Florence, Italy
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  • Paolo Geñtilini

    1. Istituto di Clinica Medica II, Unitá di Endocrinologia, University of Florence School of Medicine, I-50134 Florence, Italy
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Abstract

Plasma levels of brain natriuretic peptide, a recently identified cardiac hormone with natriuretic activity, were measured in 11 healthy subjects, 13 cirrhotic patients without ascites, 18 nonazotemic cirrhotic patients with ascites and 6 patients with cirrhosis, ascites and functional kidney failure. Plasma levels of brain natriuretic peptide were similar in healthy subjects and cirrhotic patients without ascites (5.56 ± 0.65 and 7.66 ± 0.68 fmol/ml, respectively). In contrast, cirrhotic patients with ascites, with and without functional kidney failure, had significantly higher plasma concentrations of brain natriuretic peptide (19.56 ± 1.37 and 16.00 ± 1.91 fmol/ml, respectively) than did healthy subjects and patients without ascites (p < 0.01); no significant difference was found between the two groups of cirrhotic patients with ascites with respect to this parameter. In the whole group of cirrhotic patients included in the study, brain natriuretic peptide level was directly correlated with the degree of impairment of liver and kidney function, plasma renin activity and plasma levels of aldosterone and atrial natriuretic peptide. The results of this study indicate that brain natriuretic peptide is increased in cirrhotic patients with ascites and suggest that sodium retention in cirrhosis is not due to deficiency of this novel cardiac hormone. (HEPATOLOGY 1992;16:156–161.)

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