Yokokawa K, Mankus R, Saklayen M G, Kohno M, Yasunari K, Minami M, Kano H, Horio T, Takeda T, Mandel A K
Osaka City University Medical School, Japan.
Ann Intern Med. 1995 Jul 1;123(1):35-7. doi: 10.7326/0003-4819-123-1-199507010-00005.
To determine the involvement of nitric oxide production in hemodialysis-induced hypotension.
Examination of nitric oxide synthesis, cyclic guanosine 3'5'-monophosphate (cGMP) levels, and endothelin-1 levels in plasma before and after hemodialysis.
Veterans Affairs medical center.
13 patients with end-stage renal failure who were receiving hemodialysis: Six patients had hypotensive episodes during dialysis and 7 did not.
Patients received heparin at a bolus dose of 2000 U at the initiation of dialysis followed by 1000 U/h during 4-hour hemodialysis sessions.
Nitric oxide production markedly increased during hemodialysis-induced hypotensive episodes; this increase was not seen in patients who did not have a hypotensive episode. In both groups, the plasma cGMP and endothelin-1 levels decreased after hemodialysis. According to multiple regression analysis, standard coefficients of nitric oxide production, plasma cGMP levels, and endothelin-1 levels with mean blood pressure after hemodialysis were -0.743, -0.07, and 0.31, respectively.
Nitric oxide production increased in patients who had a hypotensive episode during hemodialysis but did not increase in those who did not have a hypotensive episode.
