Changes in catecholamine level in hypotensive patients subjected to dialysis

An increase in the long-term survival ratio of patients with chronic renal failure has led to an increase in constant hypotensive accidents and cases of hypotension attacks during hemodialysis in spite of no prior abnormal physical findings, leading to difficulty in maintaining further dialysis. Many investigators have examined the plasma noradrenalin (NA) levels in dialysis patients, but the relationship between blood pressure and the plasma catecholamine concentration remains unknown. In our time-course plasma catecholamine level measurements, no significant difference was observed between the pre- and post-hemodialysis period, but a comparison of the plasma catecholamine levels for respective time periods revealed that a decrease in plasma NA levels corresponded to a decrease in blood pressure 3 to 4 hours after the beginning of hemodialysis. Administration of amezinium, which was thought to increase the plasma NA level, succeeded in maintaining and facilitated maintenance of a favorable blood pressure. The plasma NA concentration was considered to be related to a reduction of blood pressure during hemodialysis.