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ROBERT S. ZIMMERMAN, BROOKS S. EDWARDS, THOMAS R. SCHWAB, DENISE M. HEUBLEIN, JOHN C. BURNETT, Atrial Natriuretic Peptide during Mineralocorticoid Escape in the Human, The Journal of Clinical Endocrinology & Metabolism, Volume 64, Issue 3, 1 March 1987, Pages 624–627, https://doi.org/10.1210/jcem-64-3-624
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The relationship between plasma atrial natriuretic peptide (ANP) and mineralocorticoid escape was examined in six normal men (age, 20–32 yr) treated with 0.4 mg/day fludrocortisone acetate for 9–14 days. Urinary sodium excretion decreased from 162 ± 15 (sem) meq/24 h before to 97 ± 10 meq/24 h during fludrocortisone acetate administration (P < 0.05). Despite continued fludrocortisone acetate administration, sodium excretion subsequently returned to baseline (escape). Plasma ANP increased from 33 ± 6 pg/ml (control) to 55 ± 14 pg/ml on the first day of escape (P < 0.05). Escape was associated with a decrease in PRA from 0.90 ± 0.22 (control) to 0.26 ± 0.08 ng/ml·h (escape, P < 0.05). The escape phenomenon was not associated with a significant change in mean arterial pressure or glomerular filtration rate. This study demonstrates that mineralocorticoid escape is temporally related to a significant increase in circulating ANP.