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      Plasma Catecholamine Response to Postural Stimulation in Normotensive and Dialysis Hypotension-Prone Uremic Patients

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          Abstract

          The neurosympathetic responsiveness of two groups of uremics, each group treated for the same mean time by dialysis, categorized as normotensive, mean age 28.3 ± (SE) 3 years, or dialysis hypotension-prone, mean age 49.6 ± 5 years, was studied by determining plasma norepinephrine and epinephrine before and after postural activation of the sympathetic reflex arc. The study was performed on an interdialysis day and repeated 20 min before and after a regular dialysis on the following day. Standing caused norepinephrine to rise significantly in both the normotensive and the hypotension-prone groups and to a similar extent as in a control nonuremic group. Blood pressure did not change and the heart rate increased significantly. Plasma norepinephrine before dialysis 24 h later behaved in the same way, but both blood pressure and heart rate were unchanged. After dialysis, in spite of the usual increase in norepinephrine after standing, patients in the hypotension-prone group became hypotensive. These results suggest that there is a normal sympathetic responsiveness in uremics whatever their propensity for intradialysis hypotension. Moreover, dialysis does not seem to have an acute effect on the neurosympathetic response to a hypotensive stimulus. Dialysis-dependent hypotension, which appears to be more frequent in older subjects, probably reflects an impairment of the vasoconstrictor response of the vascular wall acutely induced by dialysis itself.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1981
          1981
          02 December 2008
          : 27
          : 6
          : 285-291
          Affiliations
          Division of Nephrology, Spedali Civili di Brescia, Brescia, and Department of Pharmacology, School of Medicine, University of Milan, Milan, Italy
          Article
          182072 Nephron 1981;27:285–291
          10.1159/000182072
          7266717
          © 1981 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 7
          Categories
          Original Paper

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