[The activities of the renin-angiotensin-aldosterone and sympathetic-adrenal systems during hemodialysis].

The authors analysed the dynamics of the activity of the renin-angiotensin-aldosterone, hypophyseal-adrenal, and sympathoadrenal systems in 46 patients during a hemodialysis session according to the type of hemodynamics. No essential changes were encountered in the hormone concentration in patients with normotension and "controllable" hypertension. In patients with "uncontrollable" hypertension the dialysis dehydration was attended by increased activity of the renin-angiotensin-aldosterone system, the level of cortisol and the adrenocorticotropic hormone increased slightly. Daily catecholamine excretion was 2-3.5 times below the lowest normal value. Noradrenaline clearance of the plasma membrane dialyser was 82.1 ml/min. Increase in the concentration of noradrenaline, and the activity of renin and aldosterone were encountered both in hypotension and in arterial hypertension. It is concluded that disturbed water balance, dyselectrolythemia, anemia, infectious complications, etc. are the trigger factor of decompensation of the system of the hormonal hemodynamic regulation. Substitution adrenomimetic therapy for arresting collaptoid reactions is inexpedient. Systematic use of medicinal agents should be avoided in favour of a search for an optimal dialysis regimen, should this prove ineffective the decision should be made in favour of an operation.