Acute Changes of Endothelin 1 in Children on Hemodialysis

Effect of a Hemodialysis Session on Plasma Levels of Endothelin-1 in Hypertensive and Normotensive Subjects with End-Stage Renal Failure

“…Since they studied an unselected group of ESRF subjects it is likely that both normotensives and hypertensives were included, all the more because 8 out of their 16 subjects had left ventricular hypertrophy on echocardiography. For the same reason, namely the lack of division of the study group on the basis of blood pressure values, we are not able to comment on the lack of effect of isolated ultrafiltration through non-high-flux dialyzers on plasma ET-1 reported by Peco-Antic et al [15]in children and by Niwa et al [11]in adults. However, that Peco- Antic et al [15]reported that isolated hemodialysis produced more pronounced rises in the children with hypertrophied left ventricle (and presumably with hypertension), is not totally discordant with our finding of elevated plasma ET-1 in hypertensives after the first protocol stage.…”

“…For the same reason, namely the lack of division of the study group on the basis of blood pressure values, we are not able to comment on the lack of effect of isolated ultrafiltration through non-high-flux dialyzers on plasma ET-1 reported by Peco-Antic et al [15]in children and by Niwa et al [11]in adults. However, that Peco- Antic et al [15]reported that isolated hemodialysis produced more pronounced rises in the children with hypertrophied left ventricle (and presumably with hypertension), is not totally discordant with our finding of elevated plasma ET-1 in hypertensives after the first protocol stage. Indeed, we did not apply isolated ultrafiltration in our study so that changes observed after the first stage of the dialysis session can be attributable to a combination of ultrafiltration and hemodialysis.…”

“…Indeed, we did not apply isolated ultrafiltration in our study so that changes observed after the first stage of the dialysis session can be attributable to a combination of ultrafiltration and hemodialysis. On the other hand, Ross et al [14]who studied a population of hemodialyzed children, similarly to Peco-Antic et al [15], found a correlation between the magnitude of volume loss and dialysis-induced rises of ET-1. This is consistent with the analogical correlation in our hypertensive ESRF patients and suggests that not blood depuration but ultrafiltration is pathophysiologically linked to augmentation of ET-1 production during a dialysis session.…”

“…In agreement with an earlier report by Koyama et al [4], others have also found a decrease in plasma ET-1 concentrations on hemodialysis [7, 8], in contrast to those who reported unchanged [5, 11, 13]or even increased [14]plasma ET-1 after a hemodialysis session. In addition, it was not clarified whether volume loss associated with ultrafiltration or hemodialysis is responsible for changes in plasma ET-1 associated with hemodialysis [11, 13, 14, 15, 16]. …”