0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Communications |

Increased Nitric Oxide Production in Patients with Hypotension during Hemodialysis

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; and Anil K. Mandel, MD
[+] Article and Author Information

From Osaka City University Medical School, Osaka, Japan; and Wright State University, Dayton, Ohio. Requests for Reprints: Koji Yokokawa, MD, PhD, The First Department of Internal Medicine, Osaka City University Medical School, 1-5-7 Asahi-machi, Abeno-ku, Osaka 545, Japan.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1995;123(1):35-37. doi:10.7326/0003-4819-123-1-199507010-00005
Text Size: A A A

Objective: To determine the involvement of nitric oxide production in hemodialysis-induced hypotension.

Design: Examination of nitric oxide synthesis, cyclic guanosine 3′5′-monophosphate (cGMP) levels, and endothelin-1 levels in plasma before and after hemodialysis.

Setting: Veterans Affairs medical center.

Patients: 13 patients with end-stage renal failure who were receiving hemodialysis: Six patients had hypotensive episodes during dialysis and 7 did not.

Intervention: 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.

Results: 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.

Conclusion: 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.

Figures

Grahic Jump Location
Figure 1.
Mean blood pressures (panel A); the sum of plasma nitrite (N0 2 ) and nitrate (NO 3 ) levels (panel B); plasma cyclic guanosine 3′5′-monophosphate (cGMP) levels (panel C), and plasma endothelin-1 levels (panel D) in patients with hypotensive episodes (hypotension[+]) and those without hypotensive episodes (hypotension[−]) before and after a single 4-hour hemodialysis (HD) session.tt

Asterisk indicates the paired -test; plus sign indicates the unpaired Student -test.

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)