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Cited by 519Dialysis and Renal Disease ManagementHeart Failure Treatment and ManagementBlood Pressure and Hypertension Studies

The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.

Plasma Norepinephrine Predicts Survival and Incident Cardiovascular Events in Patients With End-Stage Renal Disease

Zoccali, Carmine, Mallamaci, Francesca, Parlongo, Saverio, Cutrupi, Sebastiano, Benedetto, Francesco Antonio, Tripepi, Giovanni, Bonanno, Graziella, Rapisarda, Francesco, Fatuzzo, Pasquale, Seminara, Giuseppe, Cataliotti, Alessandro, Stancanelli, Benedetta, Malatino, Lorenzo Salvatore·2002·Circulation
DOI 10.1161/hc1102.105261
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Abstract

Background — Sympathetic tone is consistently raised in patients with end-stage renal disease (ESRD). We therefore tested the hypothesis that sympathetic activation is associated with mortality and cardiovascular events in a cohort of 228 patients undergoing chronic hemodialysis who did not have congestive heart failure at baseline and who had left ventricular ejection fraction >35%. Methods and Results — The plasma concentration of norepinephrine (NE) was used as a measure of sympathetic activity. Plasma NE exceeded the upper limit of the normal range (cutoff 3.54 nmol/L) in 102 dialysis patients (45%). In a multivariate Cox regression model that included all univariate predictors of death as well as the use of sympathicoplegic agents and β-blockers, plasma NE proved to be an independent predictor of this outcome (hazard ratio [1-nmol/L increase in plasma NE]: 1.07, 95% CI 1.01 to 1.14, P =0.03). Similarly, plasma NE emerged as an independent predictor of fatal and nonfatal cardiovascular events (hazard ratio [1-nmol/L increase in plasma NE] 1.08, 95% CI 1.02 to 1.15, P =0.01) in a model that included previous cardiovascular events, pulse pressure, age, diabetes, smoking, and use of sympathicoplegic agents and β-blockers. The adjusted relative risk for cardiovascular complications in patients with plasma NE >75th percentile was 1.92 (95% CI 1.20 to 3.07) times higher than in those below this threshold ( P =0.006). Conclusions — Sympathetic nerve overactivity is associated with mortality and cardiovascular outcomes in ESRD. Controlled trials with antiadrenergic drugs are needed to determine whether interference with the sympathetic system could reduce the high cardiovascular morbidity and mortality in dialysis patients.

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Crossref · 10.1161/hc1102.105261

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Research works printed but not linked: 4

  1. 10.1161/hyp.34.4.724 · DOI
  2. 10.1161/circ.94.4.690 · DOI
  3. Lake CR, Ziegler MG, Coleman MD, et al. Plasma levels of norepinephrine and dopamine beta-hydroxylase in CRF patients treated with dialysis. Cardiovasc Med. 1979; 15: 1099–1111.
  4. 10.1161/circ.99.16.2192 · DOI

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Metadata

Authors
Zoccali, C., Mallamaci, F., Parlongo, S., Cutrupi, S., Benedetto, F. A., Tripepi, G., Bonanno, G., Rapisarda, F., Fatuzzo, P., Seminara, G., Cataliotti, A., Stancanelli, B., & Malatino, L. S.
Affiliations
University of Catania (IT)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2002-03-19
Volume
105
Issue
11
Pages
1354-1359
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/hc1102.105261
OpenAlex
W2166904705
Cited by
519
References
36
Citations by year
2026: 7 · 2025: 11 · 2024: 12 · 2023: 16 · 2022: 15 · 2021: 14 · 2020: 20 · 2019: 11 · 2018: 20 · 2017: 29 · 2016: 31 · 2015: 30 · 2014: 38 · 2013: 27 · 2012: 31
FWCI
12.27
Type
journal article
Language
en
Update notices
correction (2002-05-07)
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
Regione Calabria
Topics
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
plasma norepinephrine, end-stage renal disease, hemodialysis, sympathetic activation, cardiovascular mortality, cardiovascular events, beta-blockers, cardiovascular risk prediction
MeSH terms
Cardiovascular Diseases, Chronic Disease, Female, Renal Dialysis, Humans, Kidney Failure, Chronic, Male, Middle Aged, Norepinephrine, Predictive Value of Tests, Risk Factors, Stroke Volume, Sympathetic Nervous System, Cohort Studies, Comorbidity, Survival Rate, Proportional Hazards Models, Survival Analysis, Ventricular Function, Left

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