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Relationship between dialysis induced hypotension and adenosine released by ischemic tissue
1Department of Internal Medicine, Branch Hospital, Nagoya University School of Medicine, Japan.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|July 1, 1992
Summary
Dialysis can cause two types of hypotension. Abrupt hypotension, unlike gradual hypotension, shows increased hypoxanthine, suggesting adenosine triphosphate degradation and adenosine release.
Area of Science:
- Nephrology
- Cardiovascular Physiology
Background:
- Dialysis-induced hypotension is a common complication.
- Two distinct types, gradual and abrupt hypotension, have been observed.
Purpose of the Study:
- To investigate the underlying biochemical mechanisms differentiating gradual and abrupt dialysis-induced hypotension.
- To explore the role of hypoxanthine and adenosine triphosphate (ATP) degradation in these hypotensive events.
Main Methods:
- Measurement of plasma hypoxanthine concentrations in patients experiencing gradual and abrupt hypotension during dialysis.
- Comparison of hypoxanthine levels before and during hypotensive episodes.
- Assessment of adenosine triphosphate (ATP) degradation and its relation to tissue ischemia.
Main Results:
- Plasma hypoxanthine concentrations were significantly elevated during abrupt hypotension compared to pre-dialysis levels.
- No significant difference in plasma hypoxanthine was observed during gradual hypotension.
- Findings suggest increased ATP degradation and tissue ischemia during abrupt hypotension.
Conclusions:
- Abrupt dialysis-induced hypotension is associated with abnormal adenosine triphosphate (ATP) degradation.
- Increased adenosine release, resulting from ATP degradation, may be the cause of abrupt hypotension.
- Adenosine's vasodilatory effects and inhibition of norepinephrine release likely contribute to abrupt hypotension.