Association of human hepatocyte growth factor with hemodialysis hypotension

Hypotension is a major cardiovascular complication of hemodialysis, and enhanced production of nitric oxide (NO) may be involved in hemodialysis hypotension. Human hepatocyte growth factor (hHGF), which induces endothelial proliferation, causes NO-mediated hypotension in animals. Because heparin, which is routinely used during hemodialysis, increases circulating hHGF concentration in humans, circulating hHGF may be involved in hemodialysis hypotension via increased NO production. To investigate the involvement of hHGF in NO production and hypotension in hemodialysis patients, we measured concentrations of serum hHGF and plasma NO3-, an index of endogenous NO production, in 114 patients undergoing maintenance hemodialysis. The mean serum hHGF concentration before dialysis was greater (p<0.01) in subjects with lower blood pressure (BP) (mean BP before dialysis < or =75 mmHg, n=16, 0.251+/-0.050 ng/ml) than in those with middle BP (mean BP before dialysis 76 to 109 mmHg, n=75, 0.143+/-0.016 ng/ml) or higher BP (mean BP before dialysis > or =110 mmHg, n=23, 0.088+/-0.017 ng/ml). The mean serum hHGF concentration after dialysis was higher in subjects with lower BP (1.854+/-0.242 ng/ml) than in those with middle BP (1.280+/-0.120 ng/ml) or higher BP (0.688+/-0.130 ng/ml). Serum hHGF concentration was positively correlated with plasma NO3- concentration (r=0.608, p=0.0001, n=114). Circulating hHGF may participate in the mechanism of chronic hemodialysis hypotension by affecting endogenous NO production.