Associations between Sympathetic Activity, Plasma Concentrations of Renin, Aldosterone, and Parathyroid Hormone, and the Degree of Intractability of Blood Pressure Control in modialysis Patients.
10.3346/jkms.2007.22.4.604
- Author:
Zoong Rock HONG
1
;
Hyo Wook GIL
;
Jong Oh YANG
;
Eun Young LEE
;
Jae Ouk AHN
;
Sae Yong HONG
Author Information
1. Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea. hwgil@sch.ac.kr
- Publication Type:Original Article
- Keywords:
Hypertension;
Hemodialysis;
Hyperparathyroidism
- MeSH:
Adult;
Aged;
Aldosterone/*blood;
Analysis of Variance;
Antihypertensive Agents/therapeutic use;
Blood Pressure/drug effects/*physiology;
Epinephrine/blood;
Female;
Humans;
Hypertension/blood/drug therapy/physiopathology;
Kidney Failure, Chronic/blood/physiopathology/therapy;
Male;
Middle Aged;
Norepinephrine/blood;
Parathyroid Hormone/*blood;
*Renal Dialysis;
Renin/*blood;
Sympathetic Nervous System/*physiology;
Urea/metabolism
- From:Journal of Korean Medical Science
2007;22(4):604-610
- CountryRepublic of Korea
- Language:English
-
Abstract:
This study was designed to examine how such factors as hemodialysis parameters, body mass index, renin and aldosterone concentrations, sympathetic nervous activity, and parathyroid hormone concentrations are associated with the control of hypertension in hemodialysis patients. Hemodialysis patients (n=114) were grouped into four categories. Group 1 had normal BP without antihypertensive medication. Group 2 needed one antihypertensive drug, Group 3 needed combination of two or three categories of antihypertensive drugs without minoxidil. Group 4 needed more than three categories of antihypertensive drugs including minoxidil. Parathyroid hormone, beta2-microglobulin, renin and aldosterone, epinephrine, norepinephrine, and hemodialysis parameters were measured. The fractional clearance of urea as Kt/V urea was significantly lower in Group 3 and Group 4 than in Group 2 (p<0.01). Concentrations of parathyroid hormone were significantly higher in Group 4 than the other groups (p<0.01). Pre-hemodialysis norepinephrine concentrations were significantly higher in Group 4 than the other groups (p<0.05). Traditional factors associated with hypertension did not seem to be relevant to the degree of hypertension in hemodialysis patients in the present study. In conclusion, poor Kt/V urea, elevated parathyroid hormone concentrations, and elevated concentrations of plasma norepinephrine seemed to be the factors that might be associated with control of hypertension in hemodialysis patients.
