Variable Levels of Plasma Catecholamines and Dopamine β-Hydroxylase in Hemodialysis Patients

Corder, Clinton N.; Sharma, Jashwant; McDonald, Robert H.

doi:10.1159/000181855

Cited by 34 publications

(8 citation statements)

References 7 publications

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“…During or after dialysis the plasma catecholamines concentration has been reported to increase [30] or decrease [28]. We found that there is no significant alteration in the concentration of plasma catecholamines, and that their levels in plasma are too variable and do not follow a trend.…”

Section: Discussionmentioning

confidence: 49%

Cardiac Arrhythmias on Hemodialysis in Chronic Renal Failure Patients

Ramírez

Brueggemeyer

Newton³

1984

Nephron

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A high incidence (40%) of cardiac arrhythmias was found in patients while on dialysis. This incidence was significantly higher than on nondialysis days. A comparison study of patients with significant cardiac arrhythmia and patients with cardiac arrhythmia was made. There was no difference in the echocardiogram, total body potassium, plasma renin activity, aldosterone, catecholamines, serum sodium, potassium and calcium between the two groups. Significant alkalinization occurred in all patients at the end of dialysis. Blood levels of total PTH and C peptide were higher in the arrhythmic patients versus the nonarrhythmic patients. No explanation was found as to why patients developed arrhythmias or what differentiated the two groups.

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Section: Discussionmentioning

confidence: 49%

Cardiac Arrhythmias on Hemodialysis in Chronic Renal Failure Patients

Ramírez

Brueggemeyer

Newton³

1984

Nephron

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“…Arterial hypertension provokes several cardiovascular alterations that reflect themselves either on the geometry of the heart and/or on the coronary blood flow inducing a high cardiovascular risk [1], Left ventricular hypertrophy (LVH) confers an independent and significant risk for premature cardiovascular morbidity and mortality [2], and it represents an independent risk factor related to the overall mortality in chronic uremic (CU) patients under hemodialytic treatment [3], LVH in CU patients is often asymmetric, affecting more the interventricular septum than the posterior wall [3][4][5], If the features of hemodynamic and mechanical stress in hypertension are now more easily determined by the available investigation techniques, on the contrary many pathophysiologic aspects linked to metabolic and neu roendocrine alterations are more complex mechanisms to examine. Chronic renal failure itself can influence the neuroendocrine response [6][7][8]. Thus, in hypertension associated with chronic renal failure we observe both car diovascular factors derived from hypertension and from renal failure.…”

mentioning

confidence: 77%

High Prevalence of Myocardial Ischemia and Vasoconstrictive Hormonal Release in Hypertension during Chronic Renal Failure

Napoli

Gregorio²,

Sorice³

et al. 1997

Nephron

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Objective: Indexes of myocardial ischemia and vasoconstrictive hormonal release were evaluated in order to investigate the difference between essential hypertension and hypertension during chronic renal failure. Background: Arterial hypertension induces several cardiovascular alterations that reflect themselves either on the heart and/or on the coronary blood flow enhancing the cardiovascular risk. Since chronic renal failure can influence the neuroendocrine response, various mechanisms involved in hypertension during chronic renal failure are still unclear. High endothelin 1 (ET-1) levels have been found both in arterial hypertension and during chronic renal failure. Interestingly, either ET-1 or catecholamines seem also to be implied in the pathogenesis of myocardial ischemia. Methods: 20 hypertensive uremic and 20 essentially hypertensive patients underwent echocardiographic wall motion and wall thickening analysis performed at baseline and immediately after the end of exercise. Simultaneously, myocardial perfusion was evaluated by ^99mTc-MIBI-SPECT. In addition, plasma norepinephrine and ET-1 concentrations were measured at baseline and at peak exercise. Results: The segmental radionuclide analysis showed a greater ischemic degree in hypertensive uremic patients. Yet, we were able to identify one or more regions of the left ventricle in which both systolic thickening measurements and wall motion after exercise were impaired. After exercise, wall thickening impairment was correlated with both wall motion abnormalities (r = 0.72, p < 0.01) and MIBI ischemic grade (r = 0.82, p < 0.001). Basal and after-exercise plasmatic norepinephrine and endothelin levels were higher in hypertensive uremic than in essentially hypertensive patients. Moreover, there was a significant correlation between increments in norepinephrine concentration and MIBI perfusion defects, and between the increment in ET-1 concentration and both MIBI perfusion defects, or kinetic alterations assessed by wall motion as well as by wall thickening. Conclusions: This is the first cross-sectional study in which a higher degree of myocardial ischemia has been observed in hypertensive uremic patients combined with an enhanced plasma release of both norepinephrine and ET-1. This phenomenon may contribute to enhance the cardiovascular risk of these patients.

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“…9, 12, 13, 18, 19], but always less than 3-fold. Dopamine was approximately double in the hemo dialysis group [12,13,17] with a single exception [11],…”

Section: Discussionmentioning

confidence: 92%

Diagnostic Considerations in Pheochromocytoma and Chronic Hemodialysis: Case Report and Review of the Literature

Stümvoll

Radjaipour²,

Seif³

1995

Am J Nephrol

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We present a patient on long-term hemodialysis (LTH) discovered to have a pheochromocytoma. A thorough workup pertaining his catecholamine status was performed, and intraoperative catecholamine changes were monitored. This condition poses some analytical difficulties as both interpretation of plasma catecholamine measurements and determination of their metabolic products are impaired. The literature about catecholamines with respect to hemodialysis is reviewed, and the known cases of pheochromocytoma in LTH patients are discussed. Predialysis norepinephrine concentrations were almost consistently elevated though less than 3-fold when compared to normal controls. Epinephrine is not significantly different in both groups. At least a 3.3-fold increase of epinephrine or norepinephrine in LTH patients with adrenal pheochromocytomas is observed. We conclude that plasma epinephrine elevations can be evaluated in the conventional manner, and norepinephrine concentrations beyond a 3-fold elevation should raise the suspicion of a pathological catechol excess syndrome. The interpretation of plasma homovanillic acid and vanillylmandelic acid in this condition is complicated by the lack of data in LTH patients without pheochromocytoma. Markedly elevated baseline concentrations for these parameters are assumed.

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Variable Levels of Plasma Catecholamines and Dopamine β-Hydroxylase in Hemodialysis Patients

Cited by 34 publications

References 7 publications

Cardiac Arrhythmias on Hemodialysis in Chronic Renal Failure Patients

Cardiac Arrhythmias on Hemodialysis in Chronic Renal Failure Patients

High Prevalence of Myocardial Ischemia and Vasoconstrictive Hormonal Release in Hypertension during Chronic Renal Failure

Diagnostic Considerations in Pheochromocytoma and Chronic Hemodialysis: Case Report and Review of the Literature

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