Document Detail

Response of vasoactive substances to reduction of blood volume during hemodialysis in hypotensive patients.
MedLine Citation:
PMID:  8491049     Owner:  NLM     Status:  MEDLINE    
Hypotension is a frequent complication in patients subjected to regular hemodialysis. Insufficient regulation of blood pressure following dialysis with ultrafiltration has been attributed to a lack in hormone activation. To determine whether altered production of vasoactive hormones is involved in the breakdown of blood pressure regulation during hemodialysis (HD), blood volume (BV), atrial natriuretic peptide (ANP), plasma renin activity (PRA), aldosterone (Aldo), norepinephrine (NE), epinephrine (Epi), intact immunoreactive parathyroid hormone (iPTH) and arginine vasopressin (AVP) were examined. The relative BV was measured by continuous hemoglobinometry during the HD period of about 240 min. The total decrease in BV at the end of treatment was 23.5 +/- 4.8% of the pretreatment value. Systolic blood pressure (SBP) was 99.6 +/- 23.0 mmHg before dialysis compared with 74.6 +/- 18.8 mmHg at the end of dialysis and heart rate (HR) increased from 76.3 +/- 5.5/min before to 92.0 +/- 10.0/min at the end of dialysis. Despite the wide range of interindividual variance, the hormonal changes indicate that hypotensive patients under HD develop reduced sensitivity of the angiotensin-renin, adrenergic and AVP systems to volumetric stimuli. A paradoxical activation in iPTH and PRA independent Aldo secretions is apparent.
B Heintz; K Reiners; U Gladziwa; R Kirsten; K Nelson; D Wieland; J Riehl; H Mann; H G Sieberth
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  39     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-06-17     Completed Date:  1993-06-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  198-204     Citation Subset:  IM    
2nd Medical Clinic, Technical University of Aachen, Germany.
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MeSH Terms
Aldosterone / blood
Arginine Vasopressin / blood
Atrial Natriuretic Factor / blood
Blood Pressure / physiology
Blood Volume / physiology*
Epinephrine / blood
Heart Rate / physiology
Hormones / blood*
Hypotension / physiopathology*
Kidney Failure, Chronic / physiopathology,  therapy*
Middle Aged
Norepinephrine / blood
Parathyroid Hormone / blood
Renal Dialysis*
Renin / blood
Reg. No./Substance:
0/Hormones; 0/Parathyroid Hormone; 113-79-1/Arginine Vasopressin; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 52-39-1/Aldosterone; 85637-73-6/Atrial Natriuretic Factor; EC

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