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Effect of sympathetic and plasma renin activity on hemodialysis hypertension

D Grekas1, I Kalevrosoglou, M Karamouzis

  • 1First Medical Department, University Hospital AHEPA, Thessaloniki, Greece.

Clinical Nephrology
|March 28, 2001
PubMed

Insights

Sympathetic activity, measured by plasma catecholamines, does not appear to be linked to hypertension in hemodialysis patients. Further research is needed to understand blood pressure control in this population.

Area of Science:

  • Nephrology
  • Cardiovascular Physiology
  • Endocrinology

Background:

  • Poor blood pressure control in hemodialysis (HD) patients remains poorly understood.
  • Excess weight and achieved dry weight do not differ between hypertensive and normotensive HD patients.
  • Sympathetic nervous system activity is investigated as a potential factor in HD hypertension.

Purpose of the Study:

  • To investigate the role of sympathetic activity and plasma renin-aldosterone in hemodialysis (HD) hypertension.
  • To compare these factors between hypertensive and normotensive HD patients.

Main Methods:

  • Studied 10 hypertensive and 10 normotensive HD patients.
  • Measured plasma aldosterone (ALDO), renin activity (PRA), adrenaline, and noradrenaline before and after HD.
  • Analyzed one month of dialysis records, including mean arterial blood pressure (MAP).

Main Results:

  • Hypertensive patients showed higher pre-dialysis plasma renin activity (PRA) and plasma aldosterone (ALDO) compared to normotensive patients.
  • Plasma ALDO levels correlated significantly with fluid volume removed by ultrafiltration (p < 0.05).
  • Neither PRA nor plasma catecholamine levels (adrenaline, noradrenaline) correlated with mean arterial blood pressure (MAP) or body weight changes.

Conclusions:

  • Sympathetic activity, indicated by plasma catecholamine levels, is not associated with hemodialysis hypertension.
  • The findings suggest that other mechanisms may be responsible for hypertension in HD patients.
Abstract

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