Norepinephrine and renin activity in chronic renal failure. Evidence for interacting roles in hemodialysis hypertension

Stephen C Textor, H. Gavras, C. P. Tifft, D. B. Bernard, B. Idelson, H. R. Brunner

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Abstract

To assess the interaction between adrenergic activity and blood pressure regulation in patients with chronic renal failure, plasma norepinephrine (NE) and plasma renin activity (PRA) were measured before and after vigorous ultrafiltration. The significance of PRA was further assessed by angiotensin blockade with saralasin. Two patterns of response were defined: nine patients had low levels of PRA before and after hemodialysis. These patients showed a net fall in norepinephrine and no angiotensin dependence at any time. Failure to stimulate either PRA or norepinephrine was also observed during period of marked hypotension. Seven other patients had higher PRA, which rose during hemodialysis. This was associated with an increase in NE and postdialysis angiotensin dependence. Patients experiencing hypotension in this group showed a sharp rise in NE, suggesting baroceptor-mediated adrenergic stimulation. In all patients sustaining hypotension during therapy, postdialysis PRA was closely correlated with NE. These results indicate that hemodialysis mobilizes the renin-angiotensin system to maintain hypertension in a greater proportion of dialysis patients than previously supposed and that impaired renin release following hypotension may represent uremic autonomic dysfunction.

Original languageEnglish (US)
Pages (from-to)294-299
Number of pages6
JournalHypertension
Volume3
Issue number3 I
StatePublished - 1981
Externally publishedYes

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ASJC Scopus subject areas

  • Internal Medicine

Cite this

Textor, S. C., Gavras, H., Tifft, C. P., Bernard, D. B., Idelson, B., & Brunner, H. R. (1981). Norepinephrine and renin activity in chronic renal failure. Evidence for interacting roles in hemodialysis hypertension. Hypertension, 3(3 I), 294-299.