title: Plasma nitrate/nitrite removal by peritoneal dialysis might predispose infants with low blood pressure to cerebral ischaemia.
abstract: The underlying pathogenic mechanisms of neurological complications in infants undergoing peritoneal dialysis (PD) are poorly understood. We report on four male infants treated with PD who developed symptomatic cerebral ischaemia. Blood pressure (BP) levels were low both before the event and at presentation. In two patients, we observed that the removal of nitrate and nitrite by PD could have impaired the nitrate/nitrite--nitrite oxide (NO) pathway, a system that generates NO independently of NO synthase. Our observation suggests that low BP and reduced NO bioavailability puts infants treated with PD at risk for impaired cerebral blood flow and consequently for brain ischaemia.
authors: Department of Physiology and Pharmacology , Karolinska Institute , Stockholm , Sweden.
authors: Mattias
authors: M
authors: Carlström
authors: Karolinska Institute, Department for Clinical Science, Intervention and Technology, Division of Pediatrics , Karolinska University Hospital , Huddinge, Stockholm , Sweden.
authors: Katarina
authors: K
authors: Wide
authors: Karolinska Institute, Department for Clinical Science, Intervention and Technology, Division of Pediatrics , Karolinska University Hospital , Huddinge, Stockholm , Sweden.
authors: Mikael
authors: M
authors: Lundvall
authors: Department of Radiology , Karolinska University Hospital , Huddinge, Stockholm , Sweden.
authors: Carmen
authors: C
authors: Cananau
authors: Department of Radiology , Karolinska University Hospital , Huddinge, Stockholm , Sweden.
authors: Anders
authors: A
authors: Svensson
authors: Department of Physiology and Pharmacology , Karolinska Institute , Stockholm , Sweden.
authors: Jon O
authors: JO
authors: Lundberg
authors: Department of Renal Medicine , Karolinska University Hospital , Huddinge, Stockholm , Sweden.
authors: Peter
authors: P
authors: Bárány
authors: Karolinska Institute, Department for Clinical Science, Intervention and Technology, Division of Pediatrics , Karolinska University Hospital , Huddinge, Stockholm , Sweden.
authors: Rafael T
authors: RT
authors: Krmar
keywords: blood pressure; cerebral ischaemia; infant; nitric oxide; peritoneal dialysis