Abstract
Aim
The aim of this study was to investigate the influence of haemodialysis on plasma chromogranin A (CgA) concentration and to assess the relationship between CgA, blood pressure, occurrence of intradialytic hypotension episodes and residual renal function, respectively.
Methods
The study included 38 chronic haemodialysis patients (24 M, 14 F; mean age 56.2 ± 13.6 years). Plasma CgA and blood pressure were measured before and after a mid-week dialysis. Control group included 10 age- and sex-matched healthy subjects.
Results
Plasma CgA levels were on average 50-fold higher in HD patients than in the controls (699 ± 138 vs. 14 ± 6 U/L). In HD patients plasma CgA corrected for ultrafiltration rates significantly increased (to 836 ± 214 U/L, P < 0.001) at the end of dialysis procedure. In patients with (n = 8) and without frequent symptomatic intradialytic hypotension episodes predialysis values of CgA were similar (701 ± 169 vs. 698 ± 132 U/L) but post-dialysis were significantly lower in the former group (746 ± 312 vs. 860 ± 177 U/L; P = 0.03) despite a similar rate of ultrafiltration (2675 ± 1009 and 2583 ± 1311 ml, respectively). Accordingly, in patients with intradialytic hypotension an increase of plasma CgA during dialysis was also much lower than in patients without hypotension (45 ± 81 vs. 163 ± 144 U/L; P = 0.001).
Conclusions
CgA undergoes marked accumulation in renal failure. The increase of plasma CgA during dialysis is impaired in subjects with intradialytic hypotension episodes, which confirms the role of autonomic dysfunction in the pathogenesis of this complication.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Daugirdas JT (1990) Dialysis hypotension: a hemodynamic analysis. Kidney Int 39:233–246
Daul AE, Wang XL, Michel MC et al (1987) Arterial hypotension in chronic hemodialyzed patients. Kidney Int 32:728–735
Saul JP, Rea RF, Eckberg DL et al (1990) Heart rate and muscle sympathetic nerve variability during reflex changes of autonomic activity. Am J Physiol 258:H713–H721
Weise F, Heydenreich F, Runge U (1987) Contribution of sympathetic and vagal mechanisms to the genesis of heart rate fluctuations during orthostatic load: a spectral analysis. J Auton Nerv Syst 21:127–134
Takiyyuddin MA, Cervenka JH, Sullivan PA et al (1990) Is physiologic sympathoadrenal catecholamine release exocytotic in humans? Circulation 81:185–195
Taupenot L, Harper KL, O’Connor DT (2003) The chromogranin-secretogranin family. N Engl J Med 348:1134–1149
Deftos LJ (1991) Chromogranin A: its role in endocrine function and neuroendocrine tumor marker. Endocr Rev 12:181–187
Dimsdale JE, O’Connor DT, Ziegler MG et al (1992) Chromogranin A correlates with norepinephrine release rate. Life Sci 51:519–525
O’Connor DT, Deftos LJ (1986) Secretion of chromogranin A by peptide-producing endocrine neoplasms. N Engl J Med 314:1145–1151
Takiyyuddin MA, Parmer RJ, Kailasam MT et al (1995) Chromogranin A in human hypertension: influence of heredity. Hypertension 26:213–220
O’Connor DT, Pandlan MR, Carlton E et al (1989) Rapid radioimmunoassay of circulating chromogranin A: in vitro stability, exploration of the neuroendocrine character of neoplasia, and assessment of the effects of organ failure. Clin Chem 35:1631–1637
Hsiao RJ, Mezger MS, O’Connor DT (1990) Chromogranin A in uremia: progressive retention of immunoreactive fragments. Kidney Int 37:955–964
Pelosi G, Emdin M, Carpeggiani C et al (1999) Impaired sympathetic response before intradialytic hypotension: a study based on spectral analysis of heart rate and pressure variability. Clin Sci 96:23–31
Huan-Sheng C, Ming-Shiou W, Wan-Yu C, et al (1995) Serum soluble interleukin-2 receptor in patients with end-stage renal disease on hemodialysis. Dial Transplant 24:459–463
Tramonti G, Ferdeghini M, Annichiarico C et al (2001) Relationship between renal function and blood level of chromogranin A. Ren Fail 23:449–457
Lilley JJ, Golden J, Stone RA (1976) Adrenergic regulation of blood pressure in chronic renal failure. J Clin Invest 57:1190–1200
Izzo JL, Izzo MS, Sterns RH et al (1982) Sympathetic nervous system hyperactivity in maintenance hemodialysis patients. Trans Am Soc Artif Intern Organs 28:604–607
Ziegler MG, Kennedy B, Morrissey E et al (1990) Norepinephrine clearance, chromogranin A and dopamine beta-hydroxylase in fenal failure. Kidney Int 37:1357–1362
Stridsberg M, Oberg K, Li Q, Engstrom U et al (1995) Measurements of chromogranin A, Chromogranin B (secretogranin I), chromogranin C (secretogranin II) and pancreastatin in plasma and urine from patients with carcinoid tumors and endocrine pancreatic tumors. J Endocrinol 144:49–59
Giusti M, Sidoti M, Augeri C et al (2004) Effect of short-term treatment with low dosages of the proton-pump inhibitor omeprazole on serum chromogranin A levels in man. Eur J Endocrinol 150:299–303
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kurnatowska, I., Nowicki, M. Serum chromogranin A concentration and intradialytic hypotension in chronic haemodialysis patients. Int Urol Nephrol 38, 701–705 (2006). https://doi.org/10.1007/s11255-005-0078-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-005-0078-7