Key result
Hemodialysis induced a fall in mean arterial blood pressure during the first two hours, followed by an increase in mean norepinephrine levels, indicating a normal reaction to volume removal.
Why the study?
How does hemodialysis affect plasma catecholamines, renin activity, aldosterone, and arterial pressure in patients on chronic hemodialysis?
Observational (n=84)
How does hemodialysis affect plasma catecholamines, renin activity, aldosterone, and arterial pressure in patients on chronic hemodialysis?
Answers are grounded in this paper and cite their sources.
Supports normal compensatory norepinephrine response during early hemodialysis; leaves open therapeutic implications for intradialytic hypotension.
To assess the interaction between adrenergic activity and blood pressure regulation, plasma catecholamines (CA), plasma renin activity (PRA) and plasma aldosteron (PA) were measured in 66 normal subjects and 18 dialysis patients. Prior to dialysis, blood levels of free norepinephrine (NE), epinephrine (E) and PRA were normal, but total (free and conjugated) CA as well as PA were significantly elevated. There was a spectrum of response during hemodialysis. On an average mean arterial blood pressure (MAP) fell during the first two hours of treatment, concomitantly followed by an increase in mean NE level. Whereas PRA and PA were highest at the end of treatment, mean free NE returned promptly to predialysis values through the late dialysis period. Severe hypotensive episodes during dialysis were associated with a baroreceptor-mediated adrenergic stimulation. These results indicate a qualitatively normal reaction of dialysis patients to volume removal and the importance of the renin-angiotensin-system in maintaining blood pressure during dialysis.
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Ratge et al. (1983) conducted an observational in Chronic Hemodialysis (n=84). Hemodialysis vs. Normal subjects / Predialysis state was evaluated on Plasma catecholamines, plasma renin activity, and plasma aldosterone. Hemodialysis induced a fall in mean arterial blood pressure during the first two hours, followed by an increase in mean norepinephrine levels, indicating a normal reaction to volume removal.
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