Zucchelli P, Catizone L, Esposti E D, Fusaroli M, Ligabue A, Zuccalà A
Nephron. 1978;21(6):317-24. doi: 10.1159/000181410.
The influence of efficient ultrafiltration without dialysis fluid was compared to the standard dialysis technique in two groups of 4 patients with chronic renal failure on maintenance haemodialysis. Supine plasma renin activity (PRA), plasma concentration of noradrenaline (NA), and adrenaline (A) and the Valsalva manoeuvre were determined before and after the period of ultrafiltration at the beginning and at the end of the experiment. The behaviour of these parameters was related to changes of blood pressure and body weight. The rapid weight loss was well tolerated during ultrafiltration only, with a significant increase of plasma catecholamines concentration; in contrast, patients treated with ultrafiltration and dialysis showed no significant increase of NA and A levels and they frequently became hypotensive. No relationship was observed between changes in PRA and those in body weight and blood pressure. Our data suggest that rapid removal of catecholamines during standard dialysis hinders the compensatory increase of the adrenergic activity and is responsible for hypotension.
在两组各4例接受维持性血液透析的慢性肾衰竭患者中，比较了无透析液的高效超滤与标准透析技术的影响。在实验开始和结束时超滤期前后，测定仰卧位血浆肾素活性（PRA）、去甲肾上腺素（NA）和肾上腺素（A）的血浆浓度以及瓦尔萨尔瓦动作。这些参数的变化与血压和体重的变化相关。仅在超滤期间能很好地耐受快速体重减轻，同时血浆儿茶胺浓度显著升高；相比之下，接受超滤和透析治疗的患者NA和A水平没有显著升高，且经常出现低血压。未观察到PRA变化与体重和血压变化之间的关系。我们的数据表明，在标准透析过程中儿茶胺的快速清除会阻碍肾上腺素能活性的代偿性增加，并导致低血压。
