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[Estimation of catecholamine release based on dialyzer clearance rate during hemodialysis]
K Yamaya1, Y Terayama, K Nigawara
1Oyokyo Kidney Research Institute, Faculty of Medicine, Japan.
Insights
Hemodialysis (HD) patients showed no significant change in free norepinephrine (f-NE) and epinephrine (f-E) levels, suggesting their release is linked to blood pressure drops during the procedure.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Background:
- Catecholamines (CAs) play vital roles in cardiovascular regulation.
- Hemodialysis (HD) is a common treatment for kidney failure, potentially affecting hormone levels.
- Understanding CA dynamics during HD is crucial for patient management.
Purpose of the Study:
- To quantify catecholamine release and clearance during hemodialysis.
- To investigate the relationship between hemodialysis parameters and CA levels.
- To explore potential mechanisms of CA release during HD.
Main Methods:
- Plasma-free and conjugated catecholamines (CAs) were measured in 10 HD patients.
- Dialyzer clearance rates for various CA forms were determined.
- Measured CA levels were compared to calculated values based on clearance rates.
Main Results:
- Free dopamine (f-DA) and conjugated CAs decreased significantly during HD.
- Free norepinephrine (f-NE) and epinephrine (f-E) showed no significant change.
- f-NE levels correlated negatively with changes in mean blood pressure (MBP), which was linked to ultrafiltration volume.
Conclusions:
- Hemodialysis may induce the release of free norepinephrine (f-NE).
- This release appears to be associated with a decrease in mean blood pressure (MBP) caused by ultrafiltration.
- Further research is needed to fully elucidate CA regulation during hemodialysis.
Abstract:
To estimate catecholamine (CA) release during hemodialysis (HD), plasma-free and conjugated CAs and their dialyzer clearance rates were measured in 10 HD patients (age; 49.8 +/- 15.2 years, duration of HD; 5.8 +/- 5.0 years). Although free dopamine (f-DA) and all conjugated CAs decreased to about one half of the pre-HD levels at the end of HD, no significant change was seen in free norepinephrine (f-NE) and epinephrine (f-E) during HD. For every CA, the clearance rate was the highest in the sulfate and the lowest in the glucuronide form, and NE was the highest in every form. In the comparison between the measured CA and calculated CA using the clearance rate and the pre-HD level, the measured values of f-NE and f-E were significantly higher than the calculated values, unlike the results for f-DA and conjugated CAs. The difference in f-NE between the measured and the calculated values correlated negatively with the change in mean blood pressure (delta MBP), and delta MBP was also correlated with the ultrafiltration volume. From these data, it was suggested that f-NE was released by the decrease of MBP due to the increase of ultra-filtration volume during HD.