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PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION

Year 2001, Volume: 14 Issue: 4, 217 - 222, 03.12.2016

Abstract

Objective: We investigated the levels of nitric oxide (NO) and its role in hypotensive episodes in hemodialysis (HD) patients.
Methods: Twelve HD patients (6 male, 6 female, mean age 47.1 ± 2.7 years, mean duration of HD
44.5 ± 8.1 months) were included in the study. Patients who demonstrated >20% reduction in mean arterial blood pressure (MAP) during any time period of HD were classified as the hypotensive group, and those who did not demonstrate >20% reduction were classified as the nonhypotensive group. NO levels were estimated from NO metabolites (NOx) measured by Greiss reaction in blood samples collected at baseline, 30, 60, 90, 120, 180 and 240 minutes of HD.
Results: Five of 12 patients demonstrated hypotensive episodes during HD. NOx concentrations were similar at the beginning and at the end of HD in hypotensive and nonhypotensive groups. NO concentrations decreased continuously throughout the HD. Percent decline of NO were also similar in both groups during the entire study period. There was
no correlation between the NO concentrations and MAP at baseline and at the end of HD.
Conclusion: We suggest that NO could not be responsible for hypotensive episodes in dialysis patients. Further studies should be performed to investigate the factors contributing to hypotensive episodes in these patients so that further therapeutic strategies may be evaluated and applied.
Key Words: Nitric oxide, Hypotension,
Hemodialysis.

References

  • /. Wehle B, Asaba H, Castenfors J, et al. Hemodynamic changes during sequential ultrafiltration and dialysis. Kidney Int 1979/15:41 1-418.
  • Hampl H, Paeper H, Unger V, Fischer C, Rese I, Kessel Kl. Hemodynamic changes during hemodialysis, sequential ultrafiltration and hemofiltration. Kidney Int I980;I8:S83-S88.
  • Yokokawa K, Mankus R, Saklayen MG, et ai. Increased nitric oxide production in patients with hypotension during hemodialysis. Ann Intern Med 1995/123:35-37.
  • Rees DD, Palmer RMJ, Moncada S. Role of endothelium-derived nitric oxide in the regulation of blood pressure. Proc Hat! Acad Sci USA 1989/86:3375-3378.
  • Beasley D, Brenner BM. Role of nitric oxide in haemodialysis hypotension. Kidney Int 1992/38S.-S96-S 100.
  • Amore A, Bonaudo R, Ghigo D, et af Enhanced production of nitric oxide by blood- dialysis membrane interaction. J Am Soc Nephrol 1995/6:1278-1283.
  • Abbott EC, Gornall AG, Sutherland DJ, Laidiaw JC, Stiefel M. The influence of a heparin-like compound on hypotension, electrolytes and aldosterone in man. Can Med /Issoc J 1966/94:1155-1164.
  • Kohno M, Yasunari K, Yokokawa K, et al.
  • Plasma immunoreactive endothelin in essential hypertension. Am J Med
  • /88:614-618.
  • Yokokowa K, Tahara H, Kohno M, et al. Hypertension associated with endothelin- secreting malignant hemangioendothelioma. Ann Intern Med 1991/114:213-215.
  • Boulanger C, Lüscher TE. Release of endothelin from the porchine aorta. Inhibition by endothelium-derived nitric oxide. J Clin Invest 1990/85:587-590.
  • Madore E, Prud'homme L, Austin JS, et al. Impact of nitric oxide on blood pressure in hemodialysis patients. Am J Kidney Dis 1997/30:665-671.
  • ¡2. Nishimura M, Takahashi H, Maruyama K, et al. Enhanced production of nitric oxide may be involved in acute hypotension during maintenance hemodialysis. Am J Kidney Dis 1998/31:809-817.
  • Tomita M, Dheenan S, Malhotra D, Shapiro Jl, Henrich WL, Santoro TJ. 31s^ Congress of ASN, 1998/A 138 7.
  • Altun B, Oyan B, Dinler Ö, et al. Hemodiyaliz hipotansiyonu ve nitrik oksid oluşumu: parnaparin ile heparinin karşılaştırılması. T Nefroloji ve Transplant Dergisi 2000/2:110- 114.
  • Nakayama M, Kawaguchi Y, Numata M, Hasegawa T, Hosoya T. Role of nitric oxide in
  • Mehmet Koç, et at
  • hypotension during hemodialysis, nephron 1998;79:490-491.
  • Cortas Nh, Wakid HW. Determination of inorganic nitrate in serum and urine by a kinetic cadmium-reduction method. Clin Chem 1990;36:1440-1443.
  • 7. Yokokawa h, Tahara fl, hohno M, Mandel Ah, Yanagisawa M, Takeda T. heparin regulates endothelin production through endothelium- derived nitric oxide in human endothelial cells. J Clin Invest 1993;92:2080-2085.
  • Yokokawa h, Mandat Ah, hohno M, et al. heparin suppresses endothelin-1 action and production in spontaneously hypertensive rats. Am J Physiol 1992;263(5Pt 2):R1035- 1041.
  • horis M, Benigni A, Boccardo P, et al. Enhanced nitric oxide synthesis in uremia: Implications for platelet dysfunction and dialysis hypotension, hidney Int 1993:44:445- 450.
  • Schmidt R, Domico J, Samsell LS, et al. Indices of activity of the nitric oxide system in hemodialysis patients. Am J hidney Dis 1998;34:228-234.
  • Tzianello A, Deferrrari G, Garibotto G, Gurreri G, Robaudo C. Renal metabolism of amino acids and ammonia in subjects with normal renal function and in patients with chronic
  • renal function and in patients with chronic renal failure. J Clin Invest 1980:65:1162- 1173.
  • Peer G, Itzhakov E, Wollman Y, et al. Methylene blue, a nitric oxide inhibitor, prevents haemodialysis hypotension. Nephrol Dial Trans 2001; 16:1436- ¡44 1.
  • Sakuma I, Togashi II, Yoshioka M, et al. Ng- methyl-L-arginine, an inhibitor of L-arginine- derived nitric oxide synhesis, stimulates renal sympathetic nerve activity in vivo. Circ Res 1992;70:607-61 I.
  • Rysz J, Luciak M, hedziora J, Blaszczyk J, Sibinska E. Nitric oxide release in the peripheral blood during hemodialysis, hidney lnt 1997;51:294-300.
  • Roccatello D, Mengozzi G, Alfieri V, et al. Early increase in blood nitric oxide, detected by electron paramagnetic resonance as nitrosylhaemoglobin, in haemodialysis. Nephrol Dial Transplant 1997; 12:292-297.
  • Converse Jr RL, Jacossen TN, Jost CMT, et al. Paradoxical withdrawal of reflex vasoconstriction as a cause of hemodialysis- induced hypotension. J Clin Invest 1992;90:1657-1665.
  • Letteri JM. Symptomatic hypotension during hemodialysis. Semin Dial 1998; 11:253-256.
Year 2001, Volume: 14 Issue: 4, 217 - 222, 03.12.2016

Abstract

References

  • /. Wehle B, Asaba H, Castenfors J, et al. Hemodynamic changes during sequential ultrafiltration and dialysis. Kidney Int 1979/15:41 1-418.
  • Hampl H, Paeper H, Unger V, Fischer C, Rese I, Kessel Kl. Hemodynamic changes during hemodialysis, sequential ultrafiltration and hemofiltration. Kidney Int I980;I8:S83-S88.
  • Yokokawa K, Mankus R, Saklayen MG, et ai. Increased nitric oxide production in patients with hypotension during hemodialysis. Ann Intern Med 1995/123:35-37.
  • Rees DD, Palmer RMJ, Moncada S. Role of endothelium-derived nitric oxide in the regulation of blood pressure. Proc Hat! Acad Sci USA 1989/86:3375-3378.
  • Beasley D, Brenner BM. Role of nitric oxide in haemodialysis hypotension. Kidney Int 1992/38S.-S96-S 100.
  • Amore A, Bonaudo R, Ghigo D, et af Enhanced production of nitric oxide by blood- dialysis membrane interaction. J Am Soc Nephrol 1995/6:1278-1283.
  • Abbott EC, Gornall AG, Sutherland DJ, Laidiaw JC, Stiefel M. The influence of a heparin-like compound on hypotension, electrolytes and aldosterone in man. Can Med /Issoc J 1966/94:1155-1164.
  • Kohno M, Yasunari K, Yokokawa K, et al.
  • Plasma immunoreactive endothelin in essential hypertension. Am J Med
  • /88:614-618.
  • Yokokowa K, Tahara H, Kohno M, et al. Hypertension associated with endothelin- secreting malignant hemangioendothelioma. Ann Intern Med 1991/114:213-215.
  • Boulanger C, Lüscher TE. Release of endothelin from the porchine aorta. Inhibition by endothelium-derived nitric oxide. J Clin Invest 1990/85:587-590.
  • Madore E, Prud'homme L, Austin JS, et al. Impact of nitric oxide on blood pressure in hemodialysis patients. Am J Kidney Dis 1997/30:665-671.
  • ¡2. Nishimura M, Takahashi H, Maruyama K, et al. Enhanced production of nitric oxide may be involved in acute hypotension during maintenance hemodialysis. Am J Kidney Dis 1998/31:809-817.
  • Tomita M, Dheenan S, Malhotra D, Shapiro Jl, Henrich WL, Santoro TJ. 31s^ Congress of ASN, 1998/A 138 7.
  • Altun B, Oyan B, Dinler Ö, et al. Hemodiyaliz hipotansiyonu ve nitrik oksid oluşumu: parnaparin ile heparinin karşılaştırılması. T Nefroloji ve Transplant Dergisi 2000/2:110- 114.
  • Nakayama M, Kawaguchi Y, Numata M, Hasegawa T, Hosoya T. Role of nitric oxide in
  • Mehmet Koç, et at
  • hypotension during hemodialysis, nephron 1998;79:490-491.
  • Cortas Nh, Wakid HW. Determination of inorganic nitrate in serum and urine by a kinetic cadmium-reduction method. Clin Chem 1990;36:1440-1443.
  • 7. Yokokawa h, Tahara fl, hohno M, Mandel Ah, Yanagisawa M, Takeda T. heparin regulates endothelin production through endothelium- derived nitric oxide in human endothelial cells. J Clin Invest 1993;92:2080-2085.
  • Yokokawa h, Mandat Ah, hohno M, et al. heparin suppresses endothelin-1 action and production in spontaneously hypertensive rats. Am J Physiol 1992;263(5Pt 2):R1035- 1041.
  • horis M, Benigni A, Boccardo P, et al. Enhanced nitric oxide synthesis in uremia: Implications for platelet dysfunction and dialysis hypotension, hidney Int 1993:44:445- 450.
  • Schmidt R, Domico J, Samsell LS, et al. Indices of activity of the nitric oxide system in hemodialysis patients. Am J hidney Dis 1998;34:228-234.
  • Tzianello A, Deferrrari G, Garibotto G, Gurreri G, Robaudo C. Renal metabolism of amino acids and ammonia in subjects with normal renal function and in patients with chronic
  • renal function and in patients with chronic renal failure. J Clin Invest 1980:65:1162- 1173.
  • Peer G, Itzhakov E, Wollman Y, et al. Methylene blue, a nitric oxide inhibitor, prevents haemodialysis hypotension. Nephrol Dial Trans 2001; 16:1436- ¡44 1.
  • Sakuma I, Togashi II, Yoshioka M, et al. Ng- methyl-L-arginine, an inhibitor of L-arginine- derived nitric oxide synhesis, stimulates renal sympathetic nerve activity in vivo. Circ Res 1992;70:607-61 I.
  • Rysz J, Luciak M, hedziora J, Blaszczyk J, Sibinska E. Nitric oxide release in the peripheral blood during hemodialysis, hidney lnt 1997;51:294-300.
  • Roccatello D, Mengozzi G, Alfieri V, et al. Early increase in blood nitric oxide, detected by electron paramagnetic resonance as nitrosylhaemoglobin, in haemodialysis. Nephrol Dial Transplant 1997; 12:292-297.
  • Converse Jr RL, Jacossen TN, Jost CMT, et al. Paradoxical withdrawal of reflex vasoconstriction as a cause of hemodialysis- induced hypotension. J Clin Invest 1992;90:1657-1665.
  • Letteri JM. Symptomatic hypotension during hemodialysis. Semin Dial 1998; 11:253-256.
There are 32 citations in total.

Details

Journal Section Original Research
Authors

Mehmet Koç This is me

Şehnaz Karan This is me

Serhan Tuğlular This is me

Çetin Özener This is me

Azra Bihorac This is me

Serpil Bilsel This is me

Emel Akoğlu This is me

Publication Date December 3, 2016
Published in Issue Year 2001 Volume: 14 Issue: 4

Cite

APA Koç, M., Karan, Ş., Tuğlular, S., Özener, Ç., et al. (2016). PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION. Marmara Medical Journal, 14(4), 217-222.
AMA Koç M, Karan Ş, Tuğlular S, Özener Ç, Bihorac A, Bilsel S, Akoğlu E. PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION. Marmara Med J. June 2016;14(4):217-222.
Chicago Koç, Mehmet, Şehnaz Karan, Serhan Tuğlular, Çetin Özener, Azra Bihorac, Serpil Bilsel, and Emel Akoğlu. “PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION”. Marmara Medical Journal 14, no. 4 (June 2016): 217-22.
EndNote Koç M, Karan Ş, Tuğlular S, Özener Ç, Bihorac A, Bilsel S, Akoğlu E (June 1, 2016) PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION. Marmara Medical Journal 14 4 217–222.
IEEE M. Koç, Ş. Karan, S. Tuğlular, Ç. Özener, A. Bihorac, S. Bilsel, and E. Akoğlu, “PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION”, Marmara Med J, vol. 14, no. 4, pp. 217–222, 2016.
ISNAD Koç, Mehmet et al. “PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION”. Marmara Medical Journal 14/4 (June 2016), 217-222.
JAMA Koç M, Karan Ş, Tuğlular S, Özener Ç, Bihorac A, Bilsel S, Akoğlu E. PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION. Marmara Med J. 2016;14:217–222.
MLA Koç, Mehmet et al. “PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION”. Marmara Medical Journal, vol. 14, no. 4, 2016, pp. 217-22.
Vancouver Koç M, Karan Ş, Tuğlular S, Özener Ç, Bihorac A, Bilsel S, Akoğlu E. PLASMA NITRIC OXIDE CONCENTRATIONS DURING DIALYSIS INDUCED HYPOTENSION. Marmara Med J. 2016;14(4):217-22.