Plasma stable nitric oxide end products and endothelin-1 states in patients undergoing hemodialysis due to chronic end stage rena disease

ABSTRACT

In patients with end-stage renal disease [ESRD], it is essential to mandate an active screening for high risk factors of coronary atherosclerosis through periodical clinical examination and determination of the traditional and non traditional risk factors for cardiovascular disease [CVD]. Determination of two novel biochemical atherogenic risk factors plasma nitric oxide [NO] metabolites [nitrite NO2 and nitrate NO3] and endothelin-1 [ET-1] concentrations in patients with end stage renal disease who were undergoing hemodialysis. The present study population was classified into [i] A healthy reference [control] group which comprised 13 clinically healthy blood donors or patients' relatives and [ii] ESRD group which comprised 19 patients with chronic end stage renal failure [ESRD] who were undergoing intermittent hemodialysis [HD] All patients and controls were subjected for determination of plasma native NO-2/NO-3 concentrations by a colorimetric assay and plasma ET-1 concentrations using an enzyme immunometric immunoassay [EIA]. Plasma total nitrites [NO-2,+NO-3], native nitrites and calculated nitrates [umol/mi] and plasma ET-l [pg/mi] levels were significantly higher in ESRD patients both before and after dialysis sessions than their corresponding levels of healthy controls. Hemodialysis sessions induced non significant increase of NO metabolites [NOx, NO2 and NO3] and ET-1 levels above the predialysis values. However, nitrate native nitrite ratios in the HD-patients both before and after dialysis [1.7 1 and 1.5 1] were significantly lower than the corresponding normal ratio [3.11]. Plasma total nitrites comprised 21.2% native nitrites in healthy subjects. The native nitrites fraction increased to 37.0% and 40.0% of the total nitrites in ESRF patients immediately before and after HD sessions, respectively. Patients with ESRD who were undergoing hemodialysis presented significant increase of novel vasoactive CVD risk factors [NO and PT-I] when compared with the corresponding healthy reference values. Although there was a significant correlation between No meyabolites and ET-1, plasma NO metabolites concentrations did not necessarily reflect the hemodynamically active plasma NO component