RESUMO
Serum levels of Nitrite and Nitrate [NO2 + NO3], ET-1, IL-1 and TNF alpha have been estimated in 20 patients with end stage renal failure [ESRF] undergoing regular hemodialysis [HD] treatment in a trial to explain the hypotension occurring in some of these patients. According to the incidence of hypotension, patients were divided into GI [n=10] hypotension prone patients and GII [n=10] hypotension resistant patient [normotensives]. Clinical examination with measurement of systolic and mean arterial blood pressure was done to all cases before and after hemodialysis session. After HD, GI showed significnat increase in serum levels of [NO2 + NO3], IL-1 and TNF; where as a significant increase in serum ET-1 level was noticed. GII showed no significant change in serum level of the 4 parameters mentioned above. In hypotensive patients there was a significant positive correlation between [NO2 + NO3] and the duration of dialysis, and a significant negative correlation between [NO2 + NO3] and post dialysis systolic blood pressure, also between IL-1 and ET-1. From the previous results it could be concluded that the cascular endothelial factors studied [NO and ET-1] together with the inflammatory cytokines IL-1 and TNF contribute in the development of HD induced hypotension in ESRF subjects which is evidenced by: - The coupling of decrease of BP and increase in NO2 + NO3 level after HD in group I. - ET-I level, which is a powerful vasoconstrictor, showed a significant decrease post dialysis. - Cytokines [IL-1 and TNF alpha] levels, which are potent NO inducers, were found to be significantly increased post dialysis in group I