The effect of an angiotensin antagonist (saralasin) on arterial pressure and plasma aldosterone in hemodialysis-resistant hypertensive patients.
The effect of an angiotensin II antagonist (saralasin) on arterial pressure, plasma renin activity (PRA) and plasma aldosterone concentration (PAC) was assessed in seven dialysis-resistant hypertensive patients. During saralasin infusion performed before hemodialysis, mean arterial pressure fell by 8 to 18.3% in six out of the seven subjects; arterial pressure was normalized in three of them. After hemodialysis (6 subjects), a normal arterial pressure was achieved in five patients. One patient was resistant to saralasin before and after dialysis. A negative correlation (r = 0.62) was obtained between pre-infusion PRA and the change in mean arterial pressure induced by saralasin. Post-infusion PRA increased in saralasin responsive patients, the change in PRA being correlated (r = 0.82) with the pre-infusion PRA. Plasma aldosterone concentration was variably affected by saralasin; a negative correlation between pre-infusion PAC and the absolute change in PAC during saralasin was obtained (r = 0.72). The role of angiotensin II in the maintenance of a high arterial pressure in chronic dialysis patients was demonstrated. In saralasin-resistant patients, more vigorous ultrafiltration is proposed.
D000328:Adult; D000450:Aldosterone / Q000097:blood*; D000804:Angiotensin II / Q000031:analogs & derivatives* / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005374:Filtration; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012083:Renin / Q000097:blood; D012504:Saralasin / Q000494:pharmacology*
D000804:Angiotensin II; D000450:Aldosterone; D012083:Renin; D012504:Saralasin