Associations between sympathetic activity, plasma concentrations of renin, aldosterone, and parathyroid hormone, and the degree of intractability of blood pressure control in modialysis patients.
This study was designed to examine how such factors as hemodialysis parameters, body mass index, renin and aldosterone concentrations, sympathetic nervous activity, and parathyroid hormone concentrations are associated with the control of hypertension in hemodialysis patients. Hemodialysis patients (n=114) were grouped into four categories. Group 1 had normal BP without antihypertensive medication. Group 2 needed one antihypertensive drug, Group 3 needed combination of two or three categories of antihypertensive drugs without minoxidil. Group 4 needed more than three categories of antihypertensive drugs including minoxidil. Parathyroid hormone, beta2-microglobulin, renin and aldosterone, epinephrine, norepinephrine, and hemodialysis parameters were measured. The fractional clearance of urea as Kt/V urea was significantly lower in Group 3 and Group 4 than in Group 2 (p<0.01). Concentrations of parathyroid hormone were significantly higher in Group 4 than the other groups (p<0.01). Pre-hemodialysis norepinephrine concentrations were significantly higher in Group 4 than the other groups (p<0.05). Traditional factors associated with hypertension did not seem to be relevant to the degree of hypertension in hemodialysis patients in the present study. In conclusion, poor Kt/V urea, elevated parathyroid hormone concentrations, and elevated concentrations of plasma norepinephrine seemed to be the factors that might be associated with control of hypertension in hemodialysis patients.
Hong
Zoong Rock
ZR
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
Gil
Hyo Wook
HW
Yang
Jong Oh
JO
Lee
Eun Young
EY
Ahn
Jae Ouk
JO
Hong
Sae Yong
SY
D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D004837:Epinephrine / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood*; D006435:Renal Dialysis; D012083:Renin / Q000097:blood*; D013564:Sympathetic Nervous System / Q000502:physiology*; D014508:Urea / Q000378:metabolism
D000959:Antihypertensive Agents; D010281:Parathyroid Hormone; D000450:Aldosterone; D014508:Urea; D012083:Renin; D009638:Norepinephrine; D004837:Epinephrine