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Changes in plasma catecholamine levels during hemodialysis.

D B Frewin, F D Bartholomeusz, M F Cummings

    Australian and New Zealand Journal of Medicine
    |February 1, 1984
    PubMed
    Summary
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    Hemodialysis (HD) causes significant drops in plasma catecholamines like dopamine, adrenaline, and noradrenaline. This loss of catecholamines may contribute to the blood pressure changes observed during HD treatments.

    Area of Science:

    • Nephrology
    • Clinical Chemistry
    • Physiology

    Background:

    • Hemodialysis (HD) is a common treatment for kidney failure.
    • Patients undergoing HD often experience a drop in mean arterial pressure (MAP).
    • The role of catecholamines in HD-induced hemodynamic changes is not fully understood.

    Purpose of the Study:

    • To investigate changes in plasma catecholamine concentrations during routine hemodialysis.
    • To determine if catecholamine levels correlate with the observed decrease in MAP during HD.

    Main Methods:

    • Plasma concentrations of dopamine (DA), adrenaline (AD), and noradrenaline (NA) were measured in 13 patients undergoing 29 HD treatments.
    • MAP was monitored throughout the HD sessions.
    • Catecholamine levels were analyzed at various time points during and after HD.

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  • Dialysate was analyzed for the presence of catecholamines.

    • Main Results:

    • All patients showed a fall in MAP at the start of HD.
    • Plasma concentrations of DA, AD, and NA decreased significantly within the first hour of HD.
    • NA levels dropped by 15 minutes, while DA and AD levels decreased slightly later.
    • Plasma AD levels increased after two hours, but NA and DA remained lower than pre-dialysis levels.
    • Substantial amounts of NA and DA were detected in the dialysate.

    Conclusions:

    • Hemodialysis leads to a significant reduction in plasma catecholamine levels.
    • The loss of catecholamines into the dialysate may contribute to the multifactorial decrease in MAP during HD.
    • Further research is needed to fully elucidate the contribution of catecholamine depletion to HD-induced hypotension.