This Article Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by ANDERSON, G. H. Articles by STREETEN, D. H. P. Search for Related Content PubMed PubMed Citation Articles by ANDERSON, G. H., JR. Articles by STREETEN, D. H. P.

Effect of Posture on Plasma Atrial Natriuretic Hormone and Renal Function during Salt Loading in Patients with and without Postural (Idiopathic) Edema^*

Endocrine Section, Department of Medicine, State University of New York Health Science Center Syracuse, New York 13210

Address requests for reprints to: Dr. Gunnar H. Anderson, Jr., Department of Medicine, State University of New York Health Science Center, 750 East Adams Street, Syracuse, New York 13210.

The effect of posture on plasma atrial natriuretic hormone (ANH) and renal function was studied in subjects with idiopathic edema. Sixty-five subjects with edema but with no clinical evidence for cardiac, renal, or pulmonary diseases were studied after they had been off all medication for 1 week or more. They had nothing by mouth after midnight and were admitted to the Clinical Research Center at 0800 h. They voided, were weighed, and had their blood pressure and pulse measured in the recumbent and upright positions. A needle was inserted, and subjects were recumbent for 0.5 h, after which blood was drawn for measurement of plasma ANH, serum sodium, potassium, and (in 35 subjects) creatinine. They were then given 150 mL 0.14% sodium chloride solution to drink every 0.5 h for the next 6 h. Urine was collected every 0.5 h for measurement of sodium, potassium, and creatinine. After 4 h of recumbency repeat blood samples were drawn, subjects ambulated for 2 h, after which final repeat blood samples were drawn. Subjects were considered to have postural edema if their upright urinary sodium/previous 2-h urinary sodium was less than 33%, and to have a normal response if it was 33% or more. The clinical characteristics of the 34 patients with postural edema and 31 patients with a normal response were similar. Plasma ANH levels (initial, after oral saline, and after standing) were similar in the two groups, and there was no relationship between changes in ANH and urinary sodium with standing. In conclusion, under conditions of mild oral sodium chloride loading, changes in plasma ANH do not cause the abnormal sodium retention found in patients with postural edema.

^* This work was supported by a research grant (HL-26748) from the NHLBI and a Clinical Research Center Grant (RR-229) from the Division of Research Facilities and Resources, USPHS. Presented at the 71st Annual Meeting of The Endocrine Society, Seattle, WA, June 1989.

Received October 2, 1989.

This article has been cited by other articles:

				M.G. Dunnigan, J.B. Henderson, D. Hole, and A.J. Pelosi Unexplained swelling symptoms in women (idiopathic oedema) comprise one component of a common polysymptomatic syndrome QJM, November 1, 2004; 97(11): 755 - 764. [Abstract] [Full Text] [PDF]