Intradialytic hypotension: beyond hemodynamics
Intradialytic hypotension is a major complication during hemodialysis session, associated with increased risk of cardiovascular events and mortality. Its pathophysiology is believed to be multifactorial and remains not well elucidated. The aim of this study is to put forward new mechanisms behind th...
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| Veröffentlicht in: | Physiological research 2019-01, Vol.68 (5), p.793-805 |
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| creator | Hajal, J Joubran, N Sleilaty, G Chacra, D Saliba, Y Assaad, S Chelala, D Fares, N |
| description | Intradialytic hypotension is a major complication during hemodialysis session, associated with increased risk of cardiovascular events and mortality. Its pathophysiology is believed to be multifactorial and remains not well elucidated. The aim of this study is to put forward new mechanisms behind the development of intradialytic hypotension. The study included sixty-five subjects on chronic hemodialysis, divided into two groups: intradialytic hypotensive (n=12) and normotensive (n=53), according to the variation of systolic blood pressure between post-dialysis and pre-dialysis measurements. Renin and angiotensin converting enzyme I plasma concentrations increased in both groups but more likely in normotensive group. Aldosterone plasma concentration is increased in the normotensive group while it decreased in the intradialytic hypotension group. Plasma endothelin concentrations showed higher values in intradialytic hypotension group. Post-dialysis asymmetric dimethylarginine and angiotensin converting enzyme 2 plasma concentrations were significantly higher in intradialytic hypotension group as compared to normotensive one. Collectrin plasma concentrations were significantly lower in intradialytic hypotension group. Finally, post-dialysis vascular endothelial growth factor C plasma concentration significantly increased in intradialytic hypotension group. In conclusion, endothelial dysfunction characterized by a lower level of vasoactive molecule seems to play a critical role in intradialytic hypotension development. |
| doi_str_mv | 10.33549/physiolres.934080 |
| format | Article |
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Its pathophysiology is believed to be multifactorial and remains not well elucidated. The aim of this study is to put forward new mechanisms behind the development of intradialytic hypotension. The study included sixty-five subjects on chronic hemodialysis, divided into two groups: intradialytic hypotensive (n=12) and normotensive (n=53), according to the variation of systolic blood pressure between post-dialysis and pre-dialysis measurements. Renin and angiotensin converting enzyme I plasma concentrations increased in both groups but more likely in normotensive group. Aldosterone plasma concentration is increased in the normotensive group while it decreased in the intradialytic hypotension group. Plasma endothelin concentrations showed higher values in intradialytic hypotension group. Post-dialysis asymmetric dimethylarginine and angiotensin converting enzyme 2 plasma concentrations were significantly higher in intradialytic hypotension group as compared to normotensive one. Collectrin plasma concentrations were significantly lower in intradialytic hypotension group. Finally, post-dialysis vascular endothelial growth factor C plasma concentration significantly increased in intradialytic hypotension group. In conclusion, endothelial dysfunction characterized by a lower level of vasoactive molecule seems to play a critical role in intradialytic hypotension development.</description><identifier>ISSN: 0862-8408</identifier><identifier>EISSN: 1802-9973</identifier><identifier>DOI: 10.33549/physiolres.934080</identifier><identifier>PMID: 31424249</identifier><language>eng</language><publisher>Czech Republic: Institute of Physiology</publisher><subject>ACE2 ; Aged ; Aged, 80 and over ; Aldosterone ; Aldosterone - blood ; Angiotensin ; Angiotensin-converting enzyme 2 ; Arginine - analogs & derivatives ; Arginine - blood ; Biomarkers - blood ; Blood Pressure ; Cardiovascular diseases ; Endothelin-1 - blood ; Endothelins ; Endothelium, Vascular - metabolism ; Endothelium, Vascular - physiopathology ; Enzymes ; Female ; Heart failure ; Hemodialysis ; Hemodynamics ; Humans ; Hypertension ; Hypotension ; Hypotension - blood ; Hypotension - etiology ; Hypotension - physiopathology ; Kidney diseases ; Kidney Diseases - blood ; Kidney Diseases - physiopathology ; Kidney Diseases - therapy ; Male ; Membrane Glycoproteins - blood ; Middle Aged ; Mortality ; Nitric oxide ; Patients ; Peptidyl-Dipeptidase A - blood ; Renal Dialysis - adverse effects ; Renin ; Renin - blood ; Time Factors ; Vascular endothelial growth factor ; Vascular endothelial growth factor C ; Vascular Endothelial Growth Factor C - blood ; Vasoactive agents</subject><ispartof>Physiological research, 2019-01, Vol.68 (5), p.793-805</ispartof><rights>Copyright Institute of Physiology 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c342t-5f966a675fde5654e3cfd90f7e68aa9b38225d001de47ecf4029e3b46f4f83ce3</citedby><cites>FETCH-LOGICAL-c342t-5f966a675fde5654e3cfd90f7e68aa9b38225d001de47ecf4029e3b46f4f83ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31424249$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hajal, J</creatorcontrib><creatorcontrib>Joubran, N</creatorcontrib><creatorcontrib>Sleilaty, G</creatorcontrib><creatorcontrib>Chacra, D</creatorcontrib><creatorcontrib>Saliba, Y</creatorcontrib><creatorcontrib>Assaad, S</creatorcontrib><creatorcontrib>Chelala, D</creatorcontrib><creatorcontrib>Fares, N</creatorcontrib><title>Intradialytic hypotension: beyond hemodynamics</title><title>Physiological research</title><addtitle>Physiol Res</addtitle><description>Intradialytic hypotension is a major complication during hemodialysis session, associated with increased risk of cardiovascular events and mortality. Its pathophysiology is believed to be multifactorial and remains not well elucidated. The aim of this study is to put forward new mechanisms behind the development of intradialytic hypotension. The study included sixty-five subjects on chronic hemodialysis, divided into two groups: intradialytic hypotensive (n=12) and normotensive (n=53), according to the variation of systolic blood pressure between post-dialysis and pre-dialysis measurements. Renin and angiotensin converting enzyme I plasma concentrations increased in both groups but more likely in normotensive group. Aldosterone plasma concentration is increased in the normotensive group while it decreased in the intradialytic hypotension group. Plasma endothelin concentrations showed higher values in intradialytic hypotension group. Post-dialysis asymmetric dimethylarginine and angiotensin converting enzyme 2 plasma concentrations were significantly higher in intradialytic hypotension group as compared to normotensive one. Collectrin plasma concentrations were significantly lower in intradialytic hypotension group. Finally, post-dialysis vascular endothelial growth factor C plasma concentration significantly increased in intradialytic hypotension group. In conclusion, endothelial dysfunction characterized by a lower level of vasoactive molecule seems to play a critical role in intradialytic hypotension development.</description><subject>ACE2</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aldosterone</subject><subject>Aldosterone - blood</subject><subject>Angiotensin</subject><subject>Angiotensin-converting enzyme 2</subject><subject>Arginine - analogs & derivatives</subject><subject>Arginine - blood</subject><subject>Biomarkers - blood</subject><subject>Blood Pressure</subject><subject>Cardiovascular diseases</subject><subject>Endothelin-1 - blood</subject><subject>Endothelins</subject><subject>Endothelium, Vascular - metabolism</subject><subject>Endothelium, Vascular - physiopathology</subject><subject>Enzymes</subject><subject>Female</subject><subject>Heart failure</subject><subject>Hemodialysis</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypotension</subject><subject>Hypotension - blood</subject><subject>Hypotension - etiology</subject><subject>Hypotension - physiopathology</subject><subject>Kidney diseases</subject><subject>Kidney Diseases - blood</subject><subject>Kidney Diseases - physiopathology</subject><subject>Kidney Diseases - therapy</subject><subject>Male</subject><subject>Membrane Glycoproteins - blood</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nitric oxide</subject><subject>Patients</subject><subject>Peptidyl-Dipeptidase A - blood</subject><subject>Renal Dialysis - adverse effects</subject><subject>Renin</subject><subject>Renin - blood</subject><subject>Time Factors</subject><subject>Vascular endothelial growth factor</subject><subject>Vascular endothelial growth factor C</subject><subject>Vascular Endothelial Growth Factor C - blood</subject><subject>Vasoactive agents</subject><issn>0862-8408</issn><issn>1802-9973</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpFkD1PwzAQhi0EoqXwBxhQJeYEx-c4Nhuq-KhUiQVmy7HPaqomDnY65N8T0QK64YZ73-ekh5DbguYAJVcP_XZMTdhHTLkCTiU9I_NCUpYpVcE5mVMpWCanw4xcpbSjlFW0gksyg4KzadSc5OtuiMY1Zj8OjV1uxz4M2E3U7nFZ4xg6t9xiG9zYmbax6ZpceLNPeHPaC_L58vyxess276_r1dMms8DZkJVeCWFEVXqHpSg5gvVOUV-hkMaoGiRjpaO0cMgrtJ5TphBqLjz3EizCgtwfuX0MXwdMg96FQ-yml5pBAYoCY3JKsWPKxpBSRK_72LQmjrqg-keR_lekj4qm0t0JfahbdH-VXyfwDXl1ZQw</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Hajal, J</creator><creator>Joubran, N</creator><creator>Sleilaty, G</creator><creator>Chacra, D</creator><creator>Saliba, Y</creator><creator>Assaad, S</creator><creator>Chelala, D</creator><creator>Fares, N</creator><general>Institute of Physiology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BYOGL</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>20190101</creationdate><title>Intradialytic hypotension: beyond hemodynamics</title><author>Hajal, J ; Joubran, N ; Sleilaty, G ; Chacra, D ; Saliba, Y ; Assaad, S ; Chelala, D ; Fares, N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c342t-5f966a675fde5654e3cfd90f7e68aa9b38225d001de47ecf4029e3b46f4f83ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>ACE2</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aldosterone</topic><topic>Aldosterone - 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Its pathophysiology is believed to be multifactorial and remains not well elucidated. The aim of this study is to put forward new mechanisms behind the development of intradialytic hypotension. The study included sixty-five subjects on chronic hemodialysis, divided into two groups: intradialytic hypotensive (n=12) and normotensive (n=53), according to the variation of systolic blood pressure between post-dialysis and pre-dialysis measurements. Renin and angiotensin converting enzyme I plasma concentrations increased in both groups but more likely in normotensive group. Aldosterone plasma concentration is increased in the normotensive group while it decreased in the intradialytic hypotension group. Plasma endothelin concentrations showed higher values in intradialytic hypotension group. Post-dialysis asymmetric dimethylarginine and angiotensin converting enzyme 2 plasma concentrations were significantly higher in intradialytic hypotension group as compared to normotensive one. Collectrin plasma concentrations were significantly lower in intradialytic hypotension group. Finally, post-dialysis vascular endothelial growth factor C plasma concentration significantly increased in intradialytic hypotension group. In conclusion, endothelial dysfunction characterized by a lower level of vasoactive molecule seems to play a critical role in intradialytic hypotension development.</abstract><cop>Czech Republic</cop><pub>Institute of Physiology</pub><pmid>31424249</pmid><doi>10.33549/physiolres.934080</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | ACE2 Aged Aged, 80 and over Aldosterone Aldosterone - blood Angiotensin Angiotensin-converting enzyme 2 Arginine - analogs & derivatives Arginine - blood Biomarkers - blood Blood Pressure Cardiovascular diseases Endothelin-1 - blood Endothelins Endothelium, Vascular - metabolism Endothelium, Vascular - physiopathology Enzymes Female Heart failure Hemodialysis Hemodynamics Humans Hypertension Hypotension Hypotension - blood Hypotension - etiology Hypotension - physiopathology Kidney diseases Kidney Diseases - blood Kidney Diseases - physiopathology Kidney Diseases - therapy Male Membrane Glycoproteins - blood Middle Aged Mortality Nitric oxide Patients Peptidyl-Dipeptidase A - blood Renal Dialysis - adverse effects Renin Renin - blood Time Factors Vascular endothelial growth factor Vascular endothelial growth factor C Vascular Endothelial Growth Factor C - blood Vasoactive agents |
| title | Intradialytic hypotension: beyond hemodynamics |
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