Plasma concentrations of calcitonin gene‐related peptide increase during haemodialysis: relation to blood pressure*

Abstract

The authors measured the plasma levels of calcitonin gene-related peptide (CGRP), the most potent vasodilatator known, during sequential ultrafiltration and haemodialysis in 12 patients using a radio-immunoassay method. Mean plasma levels of CGRP were 70.3 +/- 16.5 (mean +/- SE) pmol l-1 at the start of treatment, it increased to 85.3 +/- 17.6 pmol l-1 during ultrafiltration and to 114.5 +/- 25.3 pmol l-1 during dialysis. Systolic blood pressure decreased during haemodialysis. Plasma levels of CGRP were negatively correlated to systolic blood pressure before and at the end of dialysis, and changes in plasma levels of CGRP were strongly correlated to changes in systolic blood pressure. The increase in CGRP levels was not correlated to the fluid removal, toxin removal or changes in osmolality. The increase in plasma levels of CGRP observed during dialysis may be an important cause of dialysis induced vasodilatation and fall in blood pressure.

Calcitonin gene-related peptide and its receptors: molecular genetics, physiology, pathophysiology, and therapeutic potentials

“…at the nerve terminal) is physiologically more important than the peptides spilled over into the circulation (12). Several in vitro assays have also been developed for measuring i-CGRP levels: RIA, immunoradiometric assay (74-87, [393][394][395][396], and RRA (85-89). There is a strong correlation between the levels of CGRP (both in plasma and in tissue extracts) measured by RIA and RRA (Fig.…”

“…However, the CGRP levels measured with the latter are consistently and significantly lower than those obtained by RIA. RIA for CGRP has been used to demonstrate the presence of i-CGRP in plasma of rats (74-84, 107) and humans (74-83, [393][394][395][396] and in the CSF in humans (75, 80). In some studies, concentrations of i-CGRP in plasma of healthy volunteers have been undetectable, but most studies showed human plasma i-CGRP levels between 2-35 pmol/ liter (73, 74, [393][394][395][396][397][398].…”

Is Calcitonin Gene-related Peptide (CGRP) a Regulator of Blood Pressure in Hemodialysis Patients?

“…1). This increase in CGRP levels was significantly correlated to the fall in blood pressure both as absolute values and as percentage change (r = 0.7, P = 0.015, r = 0.83, p = 0.0009) (23).…”

“…The relation between these peptides and the following blood pressure modulating agents: noradrenalin, adrenalin, dopamin, plasma renin activity, angiotensin II, cortisol, aldosterone and vasopressin was also studied. The relationship between plasma levels of all these vasoactive agents and blood pressure was investigated (23).…”

A Hemodialysis Patient with Heart Failure and Severe Overhydration but Near-Normal Plasma Levels of ANP

“…These ANP levels are lower than the mean predialysis and even postdialysis values in our HD popu lation. In an earlier study of 20 HD patients, we found ANP levels before dialysis of 110.5 ±13.2 (mean±SE) pmol/1 and after dialysis 75.4+10.4 pmol/1 (range 28-640 and 20-264, respectively) [13]. Normal value for healthy controls in our laboratory is 20 ±5 pmol/1.…”