Increased nitric oxide production in patients with hypotension during hemodialysis.
OBJECTIVE
To determine the involvement of nitric oxide production in hemodialysis-induced hypotension.


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


METHODS
Veterans Affairs medical center.


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


METHODS
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.


CONCLUSIONS
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
K
Osaka City University Medical School, Japan.
Mankus
R
R
Saklayen
M G
MG
Kohno
M
M
Yasunari
K
K
Minami
M
M
Kano
H
H
Horio
T
T
Takeda
T
T
Mandel
A K
AK
D000368:Aged; D006152:Cyclic GMP / Q000097:blood; D016232:Endothelins / Q000097:blood; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000097:blood; D009569:Nitric Oxide / Q000096:biosynthesis*; D009573:Nitrites / Q000097:blood; D012044:Regression Analysis; D006435:Renal Dialysis / Q000009:adverse effects*
D016232:Endothelins; D009566:Nitrates; D009573:Nitrites; D009569:Nitric Oxide; D006493:Heparin; D006152:Cyclic GMP