Cited by 88Renin-Angiotensin System StudiesDialysis and Renal Disease ManagementBlood Pressure and Hypertension Studies

Catecholamines in Peripheral Venous Plasma in Patients on Chronic Haemodialysis

McGrath, B. P., Ledingham, J. G. G., Benedict, C. R.·1978·Clinical Science

Abstract

1. Concentrations of noradrenaline and adrenaline from peripheral venous plasma were measured after 60 min of supine rest in 55 patients on chronic haemodialysis (including six anephric patients) and in 18 normal subjects. In the patients, plasma catecholamine measurements were related to concurrent measurements of blood pressure, pulse rate, plasma renin activity, plasma angiotension II, blood volume and sulphate space. 2. Mean resting peripheral venous plasma noradrenaline concentration was higher by almost twofold, but mean resting plasma adrenaline concentration was lower, in the 49 non-nephrectomized patients than in the normal subjects. In the six anephric patients, resting peripheral venous plasma noradrenaline concentrations were similar to those of normal subjects. 3. Mean resting plasma noradrenaline concentrations in peripheral venous blood were similar in normotensive and hypertensive non-nephrectomized patients; mean plasma adrenaline concentration was higher in the hypertensive patients. A positive correlation was found between plasma adrenaline and plasma renin activity but not between plasma noradrenaline and plasma renin activity. 4. Resting concentrations of both catecholamines were positively correlated with resting pulse rate and inversely related to blood volume. 5. After renal transplantation resting peripheral venous plasma noradrenaline concentrations were normal in eight patients in whom high values had been recorded whilst on chronic haemodialysis. 6. In response to 40° of head-up tilt, plasma noradrenaline increased significantly in six non-nephrectomized patients, whether sodium replete or depleted, and the changes observed in both these states were similar to those of 14 normal subjects studied on a normal diet. 7. Diastolic blood pressure increased on standing in the majority (41/55) of patients: in only four patients was there a fall in diastolic pressure of more than 5 mmHg in the erect position and in two of these blood volumes were low. 8. The cause of increased peripheral plasma noradrenaline concentrations in haemodialysis patients is uncertain.

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  • The highest level of systemic sympathetic nervous activation is seen in patients with end-stage renal disease maintained on hemodialysis, equal to or exceeding that seen in New York Heart Association class IV cardiac failure.

    “The highest level of systemic sympathetic nervous activation is seen in patients with end-stage renal disease maintained on hemodialysis, equal to or exceeding that seen in New York Heart Association class IV cardiac failure48,101.”
  • Sympathetic nervous system activation is present in patients with chronic kidney disease.

    “Sympathetic nervous system activation is present in patients with chronic kidney disease, intimated first with the finding of elevated plasma norepinephrine concentrations100–101, then more definitively with demonstration of whole-body norepinephrine spillover measurements and increased sympathetic nerve firing recorded with clinical microneurography48–51,102.”

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Authors
McGrath, B. P., Ledingham, J. G. G., & Benedict, C. R.
Affiliations
Churchill Hospital (GB)
Venue
Clinical Science
Published
1978-07-01
Volume
55
Issue
1
Pages
89-96
ISSN
0144-4107 (ISSN-L)
OpenAlex
W2412234528
Cited by
88
References
14
Citations by year
2023: 1 · 2022: 2 · 2021: 1 · 2020: 6 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 7 · 2015: 4 · 2014: 3 · 2013: 1
FWCI
2.36
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Science (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
catecholamines, norepinephrine, epinephrine, maintenance hemodialysis, plasma renin activity, angiotensin II, blood volume, pulse rate, hypertension, kidney transplantation, head-up tilt, postural blood pressure, sodium depletion, end-stage renal disease
MeSH terms
Adolescent, Adult, Aged, Angiotensin II, Blood Pressure, Blood Volume, Epinephrine, Female, Renal Dialysis, Humans, Male, Middle Aged, Nephrectomy, Norepinephrine, Posture, Pulse, Renin, Transplantation, Homologous, Veins, Kidney Transplantation

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