title: Increased nitric oxide production in patients with hypotension during hemodialysis.
abstract: 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.
authors.affiliation: Osaka City University Medical School, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yokokawa
authors.forename: R
authors.initials: R
authors.lastname: Mankus
authors.forename: M G
authors.initials: MG
authors.lastname: Saklayen
authors.forename: M
authors.initials: M
authors.lastname: Kohno
authors.forename: K
authors.initials: K
authors.lastname: Yasunari
authors.forename: M
authors.initials: M
authors.lastname: Minami
authors.forename: H
authors.initials: H
authors.lastname: Kano
authors.forename: T
authors.initials: T
authors.lastname: Horio
authors.forename: T
authors.initials: T
authors.lastname: Takeda
authors.forename: A K
authors.initials: AK
authors.lastname: Mandel
mesh_terms: 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*
chemical_list: D016232:Endothelins; D009566:Nitrates; D009573:Nitrites; D009569:Nitric Oxide; D006493:Heparin; D006152:Cyclic GMP