慢性腎不全患者の血漿抗利尿ホルモン(ADH)に関する検討
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概要
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Plasma antidiuretic hormone (ADH) was determined in 28 patients with chronic renal failure undergoing hemodialysis and in 33 normal subjects. Plasma ADH levels were significantly higher in these patients than in the normal subjects. It was also observed that plasma ADH levels did not fall significantly despite a marked decrease in effective plasma osmolality following hemodialysis. It was also noted that no correlation was obtained between the plasma ADH levels and effective plasma osmolality, both before and after hemodialysis. By analyzing the changes in blood volume and blood pressure in addition to plasma osmolality in each case, a dysfunction of ADH release in response to osmotic stimulus was found in 5 out of 28 patients. In 5 normal subjects and 6 patients with chronic renal failure, 0.5 U of ADH was infused and plasma ADH level was determined. From the slope of linear regression line between time course and ln [plasma ADH concentration], the half-life was calculated in each case. The half-life of ADH in circulating blood were 13.0±0.8 minutes and 16.1±0.7 minutes in normal subjects and uremic patient, respectively. This was significantly delayed in the patient group, suggesting that the prolonged half-life may be related, at least in part, to the high plasma ADH levels in the patient group. In eight patients undergoing chronic hemodialysis, ultrafiltration was performed for 1 hr. The concentration of urea nitrogen, creatinine, ADH, cortisol, and the permeability of each substance was determined. The plasma concentration of ADH coincided with that of the filtered solution, and no significant difference was noted between the permeability of creatinine and ADH. In contrast, cortisol, GH, prolactin and TSH were not detected in the filtered solution. A chromatographic study showed that ADH in the filtered solution coincided with the synthetic ADH. From a comparison of the permeability with molecular weight, it was suggested that ADH in the blood exists in free form without binding with plasma proteins or neurophysin.
- 札幌医科大学の論文
- 1987-12-01
札幌医科大学 | 論文
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