Apelin, plasmatic osmolality and hypotension in dialyzed patients.
OBJECTIVE
To evaluate the balance between arginine-vasopressin (AVP) and apelin during hemodialysis and its role in hypotension onset and in the inflammation status.


METHODS
We enrolled 50 patients chronically treated with hemodialysis. We assessed plasmatic osmolality, AVP, apelin, mean blood pressure (BP), high-sensitivity C-reactive protein (hsCRP) and β(2)-microglobulin.


RESULTS
Apelin rises during dialytic treatment (from 0.68 ± 0.34 to 1.89 ± 0.56 pg/ml, p < 0.0001), while plasmatic osmolality (from 325 ± 4.54 to 311 ± 1.20 mosm/kg H(2)O, p < 0.0001), AVP (from 4.28 ± 1.12 to 2.48 ± 0.50 pg/ml, p < 0.0001) and mean BP (from 124 ± 6 to 110 ± 7 mm Hg, p < 0.0001) decrease. At multivariate regression with respect to apelin, only mean BP remains (r = -0.95, p < 0.0001). We also correlated the AVP/apelin ratio with BP. Moreover, apelin is inversely related to hsCRP (r = -0.79, p < 0.0001).


CONCLUSIONS
The AVP/apelin balance changes with plasmatic osmolality variations induced by hemodialytic sessions and could represent a physiopathological marker of arterial hypo- and hypertension. Finally, apelin appears inversely related to inflammation markers.
Division of Nephrology, Department of Internal Medicine, University of Messina, Messina, Italy.
Valeria
V
Cernaro
Antonio
A
Lacquaniti
Giuseppina
G
Lorenzano
Saverio
S
Loddo
Adolfo
A
Romeo
Valentina
V
Donato
Rosaria
R
Lupica
Antoine
A
Buemi
Michele
M
Buemi
D000368:Aged; D000073861:Apelin; D001127:Arginine Vasopressin / Q000097:blood*; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007022:Hypotension / Q000097:blood* / Q000209:etiology*; D007249:Inflammation / Q000097:blood; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010949:Plasma / Q000737:chemistry; D006435:Renal Dialysis / Q000009:adverse effects*; D001613:beta 2-Microglobulin / Q000097:blood
C115436:APLN protein, human; D000073861:Apelin; D036341:Intercellular Signaling Peptides and Proteins; D001613:beta 2-Microglobulin; D001127:Arginine Vasopressin; D002097:C-Reactive Protein