Endothelin-1 and Nitric Oxide in Patients on Chronic Hemodialysis

Abstract

Aim. To establish the role of endothelin-1 and nitric oxide in the pathogenesis of hypertension in patients on chronic aemodyalisis by correlating endothelin-1 and NO plasma concentrations to the level of arterial hypertension with respect to angiotensin-converting enzyme (ACE) inhibitor therapy. Methods. We determined plasma concentrations of endothelin-1 and NO in patients on chronic hemodialysis (CHD) before and after hemodialysis treatment. The study included 30 CHD patients and 20 healthy participants as controls. Correlation to blood pressure was determined, as well as the effect of ACE inhibitors on the relationship between both endothelin-1 and NO in correlation with arterial hypertension. Main findings. Endothelin-1 plasma concentration was significantly higher in CHD patients before hemodialysis treatment than in healthy controls. Endothelin-1 plasma concentration was also significantly higher in CHD patients after hemodialysis than in healthy controls. There was a significant decrease in endothelin-1 plasma concentration after hemodialysis in comparison with its values before hemodialysis. In CHD patients, a positive correlation was found between endothelin-1 plasma concentration and systolic blood pressure after hemodialysis, irrespective of ACE inhibitors therapy. In CHD patients taking ACE inhibitors, systolic blood pressure increased with increasing endothelin-1 plasma concentration before as well as after hemodialysis. In patients taking ACE inhibitors, there was a tendency for diastolic blood pressure to increase with an increase in endothelin-1 plasma concentration after hemodialysis and to decrease with an increase in NO plasma concentration. Conclusion. NO and endothelin-1 play a significant role in etiology of the hemodynamic changes of blood pressure during the dialysis.

Coagulation activation, depletion of platelet granules and endothelial integrity in case of uraemia and haemodialysis treatment

“…Results of the study demonstrate that ProET-1 plasma concentrations are obviously increased in the subjects’ group with end-stage CKD and renal failure if compared with a group of apparently healthy subjects. Results are in accordance with the findings of other authors, who demonstrated increasing endothelin plasma concentrations with progression of renal failure [17,18]. Altered expression of microcirculation parameters with age is a commonly occurring phenomenon.…”

“…ProET-1 plasma concentrations in the subjects’ group with end-stage CKD demonstrate a statistically significant increase if compared with the subjects’ group with renal insufficiency. Endothelial injury is considered to initiate increased secretion of ET-1 and to effectuate vasoconstriction, increased intraglomerular pressure, and decreased glomerular filtration [17]. ET-1 concentrations are demonstrated to correlate with blood pressure, suggesting that ET-1 may contribute to hypertension [18].…”

“…ET-1 concentrations are demonstrated to correlate with blood pressure, suggesting that ET-1 may contribute to hypertension [18]. Reduced endothelial integrity is considered to be associated with increased incidence of cardiovascular disease [17]. Together with inflammation, hyperhomocysteinaemia and anaemia, cardiovascular disease yields an additional risk factor in subjects with end-stage CKD [19].…”

Plasma Nitrate and Incidence of Cardiovascular Disease and All‐Cause Mortality in the Community: The Framingham Offspring Study

“…In these studies, patients with renal impairment had elevated plasma NOx levels. These data are not unchallenged as some other studies report that NOx remains unchanged or even declines in renal failure . Moreover, net endogenous NOx generation may actually be lower in renal failure .…”

Deterioration of endothelial function and carotid intima-media thickness in Tibetan male adolescents exposed to second-hand smoke

“…Mature ET-1 is excreted directly into the bloodstream and accumulates in the liver and lungs. 27,28 The plasma concentration of ET-1 in adults is normally between 0.4-8.1 pg/ml, 29,30 and between 4.2 fmol/ml and 8 pg/ml in the plasma of Wistar rats. 31,32 The level of ET-1 increase with age, from 1.02 pg/ ml in young women to 2.9 pg/ml in older women.…”