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Nitric oxide synthetic capacity in relation to dialysate temperature
Charles H Beerenhout1, Marina Noris, Jeroen P Kooman
1Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands.
Blood Purification
|March 27, 2004
Summary
Lowering dialysate temperature during hemodialysis preserves vascular reactivity by maintaining nitric oxide (NO) synthesis. Cool dialysis prevents the increase in NO synthetic capacity seen with standard 37.5°C dialysate.
Area of Science:
- Nephrology
- Cardiovascular Physiology
- Biochemistry
Background:
- Hemodialysis impairs vascular reactivity, potentially linked to nitric oxide (NO) and corrected by lower dialysate temperatures.
- NO synthesis is temperature-dependent, prompting investigation into dialysate temperature's effect on plasma NO synthetic capacity.
Purpose of the Study:
- To investigate the influence of dialysate temperature on plasma nitric oxide (NO) synthetic capacity during hemodialysis.
- To compare NO synthesis during standard 37.5°C hemodialysis versus cool dialysis with extracorporeal blood cooling.
Main Methods:
- NO synthetic capacity was assessed ex vivo using [3H]L-citrulline formation from [3H]L-arginine in cultured endothelial cells.
- Plasma samples were obtained from 12 stable hemodialysis patients during sessions at 37.5°C and during cool dialysis.
Main Results:
- Cool dialysis significantly lowered core body temperature and energy transfer compared to 37.5°C dialysis.
- Systolic blood pressure decreased during 37.5°C dialysis but remained stable during cool dialysis.
- NO synthetic capacity increased during 37.5°C dialysis, but not during cool dialysis.
Conclusions:
- The stimulatory effect of uremic plasma on endothelial NO synthesis was enhanced during standard 37.5°C hemodialysis.
- Cool dialysis did not augment the NO synthetic capacity of uremic plasma, suggesting a protective effect.