E M El-Shafey1, G F El-Nagar2, M F Selim2, H A El-Sorogy3, A A Sabry4. 1. Department of Internal Medicine, Nephrology, Faculty of Medicine, Tanta University, Tanta, Egypt. shafey70@yahoo.com. 2. Department of Internal Medicine, Nephrology, Faculty of Medicine, Tanta University, Tanta, Egypt. 3. Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt. 4. Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Abstract
BACKGROUND: The etiology of hemodialysis (HD)-induced hypotension and hypertension remains speculative. There is mounting evidence that endothelin-1 (ET-1) may play a vital role in these hemodynamic changes. We examined the possible role of intradialytic changes of ET-1 in the pathogenesis of hypotension and rebound hypertension during HD. METHODS: The present study included 45 patients with end-stage renal disease (ESRD) on regular HD. They were divided according to their hemodynamic status during HD into three groups (group I had stable intradialytic hemodynamics, group II had dialysis-induced hypotension, and group III had rebound hypertension during HD). In addition, 15 healthy volunteers were included as a control group. Pulse and blood pressure were monitored before, during (every half hour), and after HD session. ET-1 level was measured at the beginning, middle, and end of HD. ET-1 was measured in the control group for comparison. RESULTS: Pre-dialysis levels of ET-1 were significantly higher in dialysis patients compared to the controls (P < 0.001); however, they were comparable in the three HD groups. The post-dialysis ET-1 level was not changed significantly in group I compared with predialysis values (14.49 +/- 2.04 vs. 14.33 +/- 2.23 pg/ml; P = NS), while the ET-1 concentration decreased significantly in group II and increased in group III in comparison to predialysis values (8.56 +/- 1.44 vs. 11.75 +/- 2.51; 16.39 +/- 3.12 vs. 11.93 +/- 2.11 pg/ml, respectively; P < 0.001). CONCLUSION: Altered ET-1 levels may be involved in the pathogenesis of rebound hypertension and hypotension during HD.
BACKGROUND: The etiology of hemodialysis (HD)-induced hypotension and hypertension remains speculative. There is mounting evidence that endothelin-1 (ET-1) may play a vital role in these hemodynamic changes. We examined the possible role of intradialytic changes of ET-1 in the pathogenesis of hypotension and rebound hypertension during HD. METHODS: The present study included 45 patients with end-stage renal disease (ESRD) on regular HD. They were divided according to their hemodynamic status during HD into three groups (group I had stable intradialytic hemodynamics, group II had dialysis-induced hypotension, and group III had rebound hypertension during HD). In addition, 15 healthy volunteers were included as a control group. Pulse and blood pressure were monitored before, during (every half hour), and after HD session. ET-1 level was measured at the beginning, middle, and end of HD. ET-1 was measured in the control group for comparison. RESULTS: Pre-dialysis levels of ET-1 were significantly higher in dialysis patients compared to the controls (P < 0.001); however, they were comparable in the three HD groups. The post-dialysis ET-1 level was not changed significantly in group I compared with predialysis values (14.49 +/- 2.04 vs. 14.33 +/- 2.23 pg/ml; P = NS), while the ET-1 concentration decreased significantly in group II and increased in group III in comparison to predialysis values (8.56 +/- 1.44 vs. 11.75 +/- 2.51; 16.39 +/- 3.12 vs. 11.93 +/- 2.11 pg/ml, respectively; P < 0.001). CONCLUSION: Altered ET-1 levels may be involved in the pathogenesis of rebound hypertension and hypotension during HD.
Authors: M Cirit; F Akçiçek; E Terzioğlu; C Soydaş; E Ok; C F Ozbaşli; A Başçi; E J Mees Journal: Nephrol Dial Transplant Date: 1995 Impact factor: 5.992
Authors: Panagiotis I Georgianos; Fani Mpoutsiouki; Erasmia Sabani; Dimitrios N Stamatiadis; Vassilios Liakopoulos; Elias V Balaskas; Pantelis E Zebekakis; Pantelis A Sarafidis Journal: Int Urol Nephrol Date: 2016-01-14 Impact factor: 2.370