Pathophysiological, cardiovascular and neuroendocrine changes in hypertensive patients during the hemodialysis session

Resource type
Authors/contributors
Title
Pathophysiological, cardiovascular and neuroendocrine changes in hypertensive patients during the hemodialysis session
Abstract
The pathophysiological mechanisms of arterial hypertension during hemodialysis (HD) in patients with end-stage renal disease (ESRD) are still poorly understood. The aim of this study is to investigate physiological, cardiovascular and neuroendocrine changes in patients with ESRD and its correlation with changes in blood pressure (BP) during the HD session. The present study included 21 patients with ESRD undergoing chronic HD treatment. Group A (study) consisted of patients who had BP increase and group B (control) consisted of those who had BP reduction during HD session. Echocardiograms were performed during the HD session to evaluate cardiac output (CO) and systemic vascular resistance (SVR). Before and after the HD session, blood samples were collected to measure brain natriuretic peptide (BNP), catecholamines, endothelin-1 (ET-1), nitric oxide (NO), electrolytes, hematocrit, albumin and nitrogen substances. The mean age of the studied patients was 43±4.9 years, and 54.6% were males. SVR significantly increased in group A (P<0.001). There were no differences in the values of BNP, NO, adrenalin, dopamin and noradrenalin, before and after dialysis, between the two groups. The mean value of ET-1, post HD, was 25.9 pg ml−1 in group A and 13.3 pg ml−1 in group B (P=<0.001). Patients with ESRD showed different hemodynamic patterns during the HD session, with significant BP increase in group A, caused by an increase in SVR possibly due to endothelial dysfunction, evidenced by an increase in serum ET-1 levels.
Publication
Journal of Human Hypertension
Volume
29
Issue
6
Pages
366-372
Date
2015-06
Journal Abbr
J Hum Hypertens
Language
en
ISSN
1476-5527
Accessed
10/18/23, 1:39 AM
Library Catalog
Rights
2015 Macmillan Publishers Limited
Extra
Number: 6 Publisher: Nature Publishing Group
Citation
Gutiérrez-Adrianzén, O. A., Moraes, M. E. A., Almeida, A. P., Lima, J. W. O., Marinho, M. F., Marques, A. L., Madeiro, J. P. V., Nepomuceno, L., da Silva Jr, J. M. S., Silva Jr, G. B., Daher, E. F., & Rodrigues Sobrinho, C. R. M. (2015). Pathophysiological, cardiovascular and neuroendocrine changes in hypertensive patients during the hemodialysis session. Journal of Human Hypertension, 29(6), 366–372. https://doi.org/10.1038/jhh.2014.93