Volume regulatory hormones in glomerular disease

Levels of plasma renin activity (ng/L per sec) and atrial natriuretic peptide (fmol/mL) in normal subjects ingesting 20 and 130 meq of sodium per day and in patients with acute glomerulonephritis and nephrotic syndrome excreting 25 meq of sodium per day. Patients with nephrotic syndrome (fourth panel) show signs of renal sodium retention since they have a hormonal profile similar to those in normal subjects excreting 130 meq/day (second panel) despite having a much lower rate of sodium excretion. There is also evidence for a contribution from underfilling as these patients do not have the profile of pure volume expansion (very low renin, very high ANP) seen in acute glomerulonephritis.