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Is there a role for endothelin-1 in the hemodynamic changes during hemodialysis?

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Abstract

Background

The etiology of hemodialysis (HD)-induced hypotension and hypertension remains speculative. There is mounting evidence that endothelin-1 (ET-1) may play a vital role in these hemodynamic changes. We examined the possible role of intradialytic changes of ET-1 in the pathogenesis of hypotension and rebound hypertension during HD.

Methods

The present study included 45 patients with end-stage renal disease (ESRD) on regular HD. They were divided according to their hemodynamic status during HD into three groups (group I had stable intradialytic hemodynamics, group II had dialysis-induced hypotension, and group III had rebound hypertension during HD). In addition, 15 healthy volunteers were included as a control group. Pulse and blood pressure were monitored before, during (every half hour), and after HD session. ET-1 level was measured at the beginning, middle, and end of HD. ET-1 was measured in the control group for comparison.

Results

Pre-dialysis levels of ET-1 were significantly higher in dialysis patients compared to the controls (P < 0.001); however, they were comparable in the three HD groups. The post-dialysis ET-1 level was not changed significantly in group I compared with predialysis values (14.49 ± 2.04 vs. 14.33 ± 2.23 pg/ml; P = NS), while the ET-1 concentration decreased significantly in group II and increased in group III in comparison to predialysis values (8.56 ± 1.44 vs. 11.75 ± 2.51; 16.39 ± 3.12 vs. 11.93 ± 2.11 pg/ml, respectively; P < 0.001).

Conclusion

Altered ET-1 levels may be involved in the pathogenesis of rebound hypertension and hypotension during HD.

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Authors and Affiliations

  1. Department of Internal Medicine, Nephrology, Faculty of Medicine, Tanta University, Tanta, Egypt

    E. M. El-Shafey, G. F. El-Nagar & M. F. Selim

  2. Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt

    H. A. El-Sorogy

  3. Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

    A. A. Sabry

Authors
  1. E. M. El-Shafey
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  2. G. F. El-Nagar
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  3. M. F. Selim
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  4. H. A. El-Sorogy
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  5. A. A. Sabry
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Correspondence to E. M. El-Shafey.

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El-Shafey, E.M., El-Nagar, G.F., Selim, M.F. et al. Is there a role for endothelin-1 in the hemodynamic changes during hemodialysis?. Clin Exp Nephrol 12, 370–375 (2008). https://doi.org/10.1007/s10157-008-0065-2

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  • DOI: https://doi.org/10.1007/s10157-008-0065-2

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