Koji Yokokawa, MD, PhD; Rita Mankus, MD; Mohammed G. Saklayen, MD; Masakazu Kohno, MD, PhD; Kenichi Yasunari, MD, PhD; Mieko Minami, MD; Hiroaki Kano, MD; Takeshi Horio, MD, PhD; Tadanao Takeda, MD; Anil K. Mandel, MD
Yokokawa K, Mankus R, Saklayen MG, Kohno M, Yasunari K, Minami M, et al. Increased Nitric Oxide Production in Patients with Hypotension during Hemodialysis. Ann Intern Med. 1995;123:35-37. doi: 10.7326/0003-4819-123-1-199507010-00005
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Published: Ann Intern Med. 1995;123(1):35-37.
To determine the involvement of nitric oxide production in hemodialysis-induced hypotension.
Examination of nitric oxide synthesis, cyclic guanosine 3′5′-monophosphate (cGMP) levels, and endothelin-1 levels in plasma before and after hemodialysis.
Veterans Affairs medical center.
13 patients with end-stage renal failure who were receiving hemodialysis: Six patients had hypotensive episodes during dialysis and 7 did not.
Patients received heparin at a bolus dose of 2000 U at the initiation of dialysis followed by 1000 U/h during 4-hour hemodialysis sessions.
Nitric oxide production markedly increased during hemodialysis-induced hypotensive episodes; this increase was not seen in patients who did not have a hypotensive episode. In both groups, the plasma cGMP and endothelin-1 levels decreased after hemodialysis. According to multiple regression analysis, standard coefficients of nitric oxide production, plasma cGMP levels, and endothelin-1 levels with mean blood pressure after hemodialysis were −0.743,-0.07, and 0.31, respectively.
Nitric oxide production increased in patients who had a hypotensive episode during hemodialysis but did not increase in those who did not have a hypotensive episode.
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Nephrology, Renal Replacement Therapy.
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