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Intradialytic hypotension: beyond hemodynamics.

J Hajal1, N Joubran, G Sleilaty

  • 1Physiology and Pathophysiology Research Laboratory, Pole of Technology and Health, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon. nassim.fares@usj.edu.lb.

Physiological Research
|August 20, 2019
PubMed
Summary
This summary is machine-generated.

Intradialytic hypotension during hemodialysis may stem from endothelial dysfunction. Lower levels of certain vasoactive molecules, like collectrin, are linked to this complication, impacting patient outcomes.

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Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Physiology

Background:

  • Intradialytic hypotension is a serious complication of hemodialysis.
  • It is associated with increased cardiovascular risks and mortality.
  • The exact causes of intradialytic hypotension are not fully understood.

Purpose of the Study:

  • To investigate novel mechanisms contributing to intradialytic hypotension.
  • To explore the role of specific vasoactive molecules in this condition.

Main Methods:

  • Studied 65 patients undergoing chronic hemodialysis.
  • Divided patients into hypotensive (n=12) and normotensive (n=53) groups.
  • Measured plasma concentrations of renin, angiotensin-converting enzyme I and 2, aldosterone, endothelin, asymmetric dimethylarginine, collectrin, and vascular endothelial growth factor C.

Main Results:

  • Renin and ACE I increased in both groups, more in normotensive.
  • Aldosterone increased in normotensive but decreased in hypotensive.
  • Endothelin, ADMA, and ACE 2 were higher in the hypotensive group.
  • Collectrin levels were lower, and VEGF-C levels were higher in the hypotensive group.

Conclusions:

  • Endothelial dysfunction appears critical in intradialytic hypotension.
  • Reduced levels of vasoactive molecules, such as collectrin, may contribute to its development.