Document Detail

Vasoactive agents and blood pressure regulation in sequential ultrafiltration and hemodialysis.
MedLine Citation:
PMID:  8294159     Owner:  NLM     Status:  MEDLINE    
Hypotension is a common and sometimes dangerous side effect of hemodialysis. Its etiology is multifactorial and largely unknown. Earlier studies on the role of endogenous blood pressure regulating agents such as catecholamines and renin have rendered conflicting results. We studied the influence of ultrafiltration and isovolemic hemodialysis separately on the plasma concentrations of the following blood pressure regulating agents: adrenaline, noradrenaline, dopamine, neuropeptide Y, calcitonin gene-related peptide (CGRP), renin (PRA), angiotensin II, vasopressin, aldosterone and cortisol. During isolated ultrafiltration, plasma levels of two strong vasoconstrictors (noradrenaline and angiotensin II) and one strong vasodilator (calcitonin gene-related peptide, CGRP) increased significantly (noradrenaline 3.24 +/- 0.60 nM to 4.31 +/- 0.55 nM; p = 0.032, angiotensin II 19.74 +/- 3.46 pmol/l to 28.49 +/- 7.24 pmol/l; p = 0.047) No symptomatic hypotension occurred. At the end of isovolemic hemodialysis, plasma levels of all the vasoconstricting agents had decreased to pretreatment values, but those of CGRP had continued to rise (from 85.3 +/- 17.6 pmol/l to 114.5 +/- 25.3 pmol/l, p = 0.031). During isovolemic hemodialysis, blood pressure fell to symptomatic levels, but was restored at the end of treatment. The study shows that hemodialysis patients respond to fluid removal by ultrafiltration with an increase in plasma levels of CGRP, noradrenaline and angiotensin II. The net effect is an appropriate vasoconstriction and adequate blood pressure is maintained during isolated ultrafiltration.(ABSTRACT TRUNCATED AT 250 WORDS)
I Odar-Cederlöf; E Theodorsson; C G Eriksson; B Hamberger; B Tidgren; C M Kjellstrand
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  16     ISSN:  0391-3988     ISO Abbreviation:  Int J Artif Organs     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1994-03-03     Completed Date:  1994-03-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  662-9     Citation Subset:  IM    
Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.
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MeSH Terms
Aldosterone / blood
Blood Pressure / physiology*
Catecholamines / blood
Heart Rate
Hydrocortisone / blood
Hypotension / blood*
Middle Aged
Neuropeptides / blood
Renal Dialysis
Renin / blood
Vasoconstrictor Agents / blood*
Vasodilator Agents / blood*
Reg. No./Substance:
0/Catecholamines; 0/Neuropeptides; 0/Vasoconstrictor Agents; 0/Vasodilator Agents; 50-23-7/Hydrocortisone; 52-39-1/Aldosterone; EC

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