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
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.
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. ;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.
Nephrology, Renal Replacement Therapy.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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