ABSTRACT
The pathophysiological mechanisms of arterial hypertension during hemodialysis (HD) in patients with end-stage renal disease (ESRD) are still poorly understood. The aim of this study is to investigate physiological, cardiovascular and neuroendocrine changes in patients with ESRD and its correlation with changes in blood pressure (BP) during the HD session. The present study included 21 patients with ESRD undergoing chronic HD treatment. Group A (study) consisted of patients who had BP increase and group B (control) consisted of those who had BP reduction during HD session. Echocardiograms were performed during the HD session to evaluate cardiac output (CO) and systemic vascular resistance (SVR). Before and after the HD session, blood samples were collected to measure brain natriuretic peptide (BNP), catecholamines, endothelin-1 (ET-1), nitric oxide (NO), electrolytes, hematocrit, albumin and nitrogen substances. The mean age of the studied patients was 43 ± 4.9 years, and 54.6% were males. SVR significantly increased in group A (P<0.001). There were no differences in the values of BNP, NO, adrenalin, dopamin and noradrenalin, before and after dialysis, between the two groups. The mean value of ET-1, post HD, was 25.9 pg ml(-1) in group A and 13.3 pg ml(-1) in group B (P = < 0.001). Patients with ESRD showed different hemodynamic patterns during the HD session, with significant BP increase in group A, caused by an increase in SVR possibly due to endothelial dysfunction, evidenced by an increase in serum ET-1 levels.
Subject(s)
Hypertension/physiopathology , Renal Dialysis , Adult , Aged , Blood Pressure , Cardiac Output , Endothelin-1/blood , Female , Humans , Hypertension/blood , Male , Middle Aged , Neurotransmitter Agents/blood , Nitric Oxide/physiology , Vascular ResistanceABSTRACT
Os autores analisam em varias linhas de pesquisas desenvolvidas no Centro de Pesquisas em Doencas Hepato-Renais, ate alcancar a fase de transplante renal humano. A tecnica do autotransplante em caes e descrita com detalhes Na preservacao renal, enfantizam o uso das substancias ricas em K e Mg, tendo o dextran 70 ou haemacell como coloide a 4oC. As alteracoes histopatologicas em 17 rins de caes autotransplantados foram analisadas, tendo sido estes animais divididos em tres grupos, segundo o tempo de preservacao. Em 42 animais divididos em tres grupos, estudamos o uso da ciclofosfamida e metilprednisolona no pre-tratamento do animal doador. As drogas eram feitas por via endovenosa 6 e 2 horas antes da nefrectomia. Finalmente, analisamos o desenvolvimento do transplante renal humano no Estado do Ceara
