title: Response of serum angiotensin converting enzyme, plasma renin activity and plasma aldosterone to conventional dialysis in patients on chronic haemodialysis.
abstract: The aim of this study was to examine serum angiotensin converting enzyme (SACE) activity and the renin-angiotensin-aldosterone system in patients on chronic haemodialysis during one routine dialysis session. Fourteen patients (8 men and 6 women; mean age 51.9 +/- 17 years) with end stage renal disease, receiving regular haemodialysis treatment for an average of 6 months, were studied. The patients were dialysed for 4 hours three times a week using cellulose membranes (cuprophan). After an overnight fast blood samples were taken from the patients before and after the haemodialysis session. Serum and plasma were separated and stored at -20 degrees C until assayed for SACE, plasma renin activity (PRA) and plasma aldosterone (PA). For comparison, SACE, PRA and PA were also measured in 8 patients after renal allotransplantation and on treatment with cyclosporin A (5 men, 3 women; mean age 38.9 +/- 12.3 years) and in 19 healthy subjects (13 men, 6 women; mean age 38.9 +/- 12.3 years). SACE levels in patients with chronic renal failure and on haemodialysis (17.55 +/- 9.03 nmol/ml/min) and in patients with renal transplantation (18.12 +/- 3.92) were significantly higher than those of the healthy subjects (9.27 +/- 1.67) (p < 0.0001, respectively). At the end of the dialysis session SACE levels in patients with chronic renal failure (14.9 +/- 7.19) did not increase in respect to pre-dialysis levels (17.55 +/- 9.03; p = 0.132). PRA and PA values increased after the dialysis session (p < 0.026 and p < 0.044, respectively). Correlation of SACE with PRA and PA was not demonstrated before or after the dialysis session. In patients with chronic renal failure and on haemodialysis our findings suggest that a disarrangement exists between the circulatory components of the reninangiotensin-aldosterone system before and after the dialysis session.
authors.affiliation: Cattedra di Nefrologia, Università di Roma La Sapienza, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Letizia
authors.forename: S
authors.initials: S
authors.lastname: Mazzaferro
authors.forename: S
authors.initials: S
authors.lastname: Morabito
authors.forename: A
authors.initials: A
authors.lastname: De Ciocchis
authors.forename: S
authors.initials: S
authors.lastname: Cerci
authors.forename: C
authors.initials: C
authors.lastname: D'Ambrosio
authors.forename: G A
authors.initials: GA
authors.lastname: Cinotti
authors.forename: D
authors.initials: D
authors.lastname: Scavo
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D007703:Peptidyl-Dipeptidase A / Q000097:blood*; D006435:Renal Dialysis; D012083:Renin / Q000097:blood*; D012084:Renin-Angiotensin System / Q000502:physiology*
chemical_list: D000450:Aldosterone; D007703:Peptidyl-Dipeptidase A; D012083:Renin