[Endothelin in patients with chronic kidney failure]

Hypertension, anaemia and arteriovenous shunts represent very important pathogenetic factors in the occurrence of cardiovascular morbidity and mortality in patients with chronic renal failure. It can be expected that endothelin (ET), the most potent vasoconstrictor known at present, can react in a significant way to the haemodynamic changes, caused by the construction of a vascular shunt or anaemia.

In 14 patients (7 men and 7 women, mean age 47 years, ranging from 19 to 70 years) the plasma ET concentration was examined before, 24 hours and 7 days after the construction of arteriovenous fistula. In 27 patients (19 men and 8 women, mean age 44 years ranging from 25 to 77 years), undergoing chronic haemodialysis treatment, ET was examined before the erythropoietin (EPO) therapy and after 2 months of EPO therapy, when partial correction of anaemia has been achieved (p < 0.01).

The construction of arteriovenous fistula by itself had no significant influence on the plasma ET concentration. Subcutaneous application of EPO in such doses, which led to gradual correction of anaemia, was not accompanied by the rise of plasma ET. The average plasma concentration of ET was significantly higher in haemodialyzed patients, when compared to healthy controls as well as to patients with chronic renal failure before haemodialysis treatment was started.