What question did this study set out to answer?

To determine whether autonomic nervous system dysfunction and adrenergic receptor abnormalities contribute to the pathophysiology of chronic hypotension in uraemic haemodialysis patients.

May 1, 1997Nephrology Dialysis Transplantation

Autonomic nervous system and adrenergic receptors in chronic hypotensive haemodialysis patients

View Full Paper

Ask AI

Bookmark

Population

17 hypotensive haemodialysis (HD) patients, 17 normotensive HD patients, and 17 control subjects (n=51)

Design

Case-control

Authors

NANuria Esforzado ArmengolHospital Clínic de Barcelona MIM. Bono Illa JBJ. Gaya Bertran

Discussion

Member takes

Implication

May underlie refractory hypotension in HD; hypothesis-generating for receptor-targeted interventions.

Key Points

To determine whether autonomic nervous system dysfunction and adrenergic receptor abnormalities contribute to the pathophysiology of chronic hypotension in uraemic haemodialysis patients.
Evaluated 17 hypotensive haemodialysis patients, 17 normotensive haemodialysis patients, and 17 healthy controls.
Assessed baroreflex and autonomic pathways using the Valsalva manoeuvre, deep-breathing test, and hand-grip isometric exercise.
Measured platelet alpha 2-adrenoceptor and lymphocyte beta 2-adrenoceptor densities via radioligand binding assays, along with lymphocyte cAMP production after isoproterenol stimulation.
Baroreflex and deep-breathing responses were impaired in all haemodialysis patients (P < 0.05), but the Valsalva ratio (P < 0.01) and hand-grip pressor response (P < 0.01) were selectively depressed in hypotensive patients.
Plasma catecholamines were elevated across haemodialysis patients (P < 0.025), with significantly higher adrenaline concentrations in hypotensive patients than in normotensive patients (P < 0.05).
Alpha 2- and beta 2-adrenoceptor densities and beta 2-adrenoceptor cAMP responses were significantly reduced in hypotensive patients compared to normotensive patients (P < 0.05) and correlated with mean blood pressure (r = 0.46, P < 0.01 and r = 0.43, P < 0.025, respectively).

Structured PICO

Population

17 hypotensive haemodialysis (HD) patients, 17 normotensive HD patients, and 17 control subjects (n=51)

Comparator

Normotensive HD patients and healthy control subjects

Outcome

Autonomic nervous system function (Valsalva manoeuvre, deep-breathing test, hand-grip test) and adrenoceptor densities/responsessurrogate

Chronic hypotension in hemodialysis patients is associated with elevated plasma adrenaline levels and subsequent downregulation of alpha 2- and beta 2-adrenoceptors, which may impair cardiovascular responses to adrenergic stimuli.

Cite This Study

Armengol et al. (1997) studied this question.

synapsesocial.com/papers/6a7caa21e6f41aaf0bcf82bd https://doi.org/10.1093/ndt/12.5.939

View Full Paper

Ask AI

Bookmark

Autonomic nervous system and adrenergic receptors in chronic hypotensive haemodialysis patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Autonomic nervous system and adrenergic receptors in chronic hypotensive haemodialysis patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider