Document Detail

Characterization of subtypes of hypertension in CAPD patients by cyclic guanosine monophosphate.
MedLine Citation:
PMID:  10357185     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: While most hypertensive patients with end-stage renal disease normalize high blood pressure with fluid removal by continuous ambulatory peritoneal dialysis (CAPD), there is a significant proportion of CAPD patients whose blood pressure can be controlled only by antihypertensive drugs. METHOD AND PATIENTS: To study the hypothesis that such patients are still volume overloaded, we used plasma cyclic guanosine monophosphate (cGMP) as a marker for hydration status. Thirty-two CAPD patients were divided into 3 groups: group 1, normotensive patients (n = 12); group 2, hypertensive patients who normalized their blood pressure with fluid removal (n = 12); group 3, hypertensive patients whose blood pressure was refractory to intensified fluid removal (n = 8). RESULTS: Mean cGMP levels were significantly higher in dialysis-sensitive hypertension (27 +/- 5 pmol/mL) than in dialysis-refractory hypertension (15 +/- 2 pmol/mL), or in normotensive patients (13 +/- 4 pmol/mL). Reduction of excess fluid in volume overloaded hypertensive CAPD patients resulted in a normalization of cGMP levels (14 +/- 8 pmol/mL), but did not affect this volume marker in patients with dialysis-resistant hypertension (10 +/- 4 pmol/mL). CONCLUSION: Plasma cGMP levels are elevated in volume overload-induced hypertension complicating CAPD. Hypertensive CAPD patients whose plasma cGMP levels are within normal limits have raised blood pressure refractory to volume removal. Our findings are consistent with the hypothesis that inadequate removal of excess volume plays a major role in a subset of patients with CAPD hypertension.
S M Lang; G Wolfram; R Gerzer; H Schiffl
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  19     ISSN:  0896-8608     ISO Abbreviation:  Perit Dial Int     Publication Date:    1999 Mar-Apr
Date Detail:
Created Date:  1999-07-15     Completed Date:  1999-07-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  143-7     Citation Subset:  IM    
Department of Nephrology, Medizinische Klinik, Klinikum Innenstadt der Universität München, Munich, Germany.
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MeSH Terms
Blood Pressure / physiology
Case-Control Studies
Cyclic GMP / blood*
Hypertension, Renal / blood*
Kidney Failure, Chronic / complications,  therapy*
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory*
Water-Electrolyte Imbalance / blood*,  etiology
Reg. No./Substance:
7665-99-8/Cyclic GMP

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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