title: Relationship between A2A adenosine receptor expression and intradialytic hypotension during hemodialysis.
abstract: BACKGROUND
  Intradialytic hypotension (IDH) is a common complication of hemodialysis sessions (HDSs). Adenosine may contribute to the drop in blood pressure during IDH events because it has hypotensive effects. As A(2A) adenosine receptor expression is essential for blood pressure control, we compared the expression of A(2A) receptors (Bmax, K(D), and messenger ribonucleic acid [mRNA] levels) in peripheral blood mononuclear cells from IDH and non-IDH patients and from controls. We also evaluated adenosine plasma levels (APLs).
  
  
  METHODS
  We included 10 hemodialyzed patients with at least three IDH events per month. We also included 11 hemodialyzed patients with no history of IDH events and 10 healthy subjects as controls.
  
  
  RESULTS
  IDH patients had higher Bmax values than non-IDH patients (mean before HDS, +86%; after HDS, +112%), whereas non-IDH patients had lower Bmax values than controls (mean -72%). K(D) values were not significantly different between patients and controls. The levels of mRNA increased significantly during HDS but without an increase in receptor expression on the cell membranes. APLs were higher in hemodialyzed patients than in controls.
  
  
  CONCLUSIONS
  We found that A(2A) receptors are more expressed in IDH patients than in non-IDH patients, whereas APL was high in all patients. Both high APL and a relative increase in A(2A) receptor expression may favor IDH events.
authors.affiliation: Service de Néphrologie et d'Hémodialyse, Hôpital de la Conception, Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Giaime
authors.forename: Louis
authors.initials: L
authors.lastname: Carrega
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Fenouillet
authors.forename: Laurence
authors.initials: L
authors.lastname: Mercier
authors.forename: Victoria
authors.initials: V
authors.lastname: Gerolami
authors.forename: Jean
authors.initials: J
authors.lastname: Ruf
authors.forename: Nicole
authors.initials: N
authors.lastname: Sauze
authors.forename: Philippe
authors.initials: P
authors.lastname: Brunet
authors.forename: Alain
authors.initials: A
authors.lastname: Saadjian
authors.forename: Yvon
authors.initials: Y
authors.lastname: Berland
authors.forename: Bertrand
authors.initials: B
authors.lastname: Dussol
authors.forename: Regis
authors.initials: R
authors.lastname: Guieu
mesh_terms: D000241:Adenosine / Q000097:blood; D000368:Aged; D001483:Base Sequence; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000235:genetics / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D043683:Receptors, Adenosine A2 / Q000235:genetics / Q000378:metabolism*; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D012333:RNA, Messenger; D043683:Receptors, Adenosine A2; D000241:Adenosine