Free and Sulfoconjugated Catecholamines in Normotensive Uremic Patients: Effects of Hemodialysis

Abstract

In 9 normotensive uremic patients undergoing chronic hemodialysis, the baseline plasma catecholamines varied widely from low-normal to very high; sulfoconjugated plasma catecholamines were constantly high. A dialysis-induced fall of all sulfated catecholamines and epinephrine was observed. Norepinephrine decreased in 5 patients and increased in 4, with a strong inverse correlation between predialysis norepinephrine and Δ norepinephrine (p < 0.0001). No correlation was evident between clinical parameters (mean arterial pressure, heart rate) and catecholamines (both predialysis and postdialysis). Significant (p < 0.0001 and p < 0.0002) inverse correlations between epinephrine and norepinephrine and their sulfoconjugation degree were demonstrated only in predialysis. Our data may support the presence of a uremic autonomic neuropathy and adrenoceptor damage.

Relating Change to Initial Value

“…Musso et al [1] analysed the change in free norepineph rine concentration after hemodialysis in relation to the predialysis levels. They found a correlation of r = -0.98 (p < 0.0001).…”

Improving Design and Analysis of Research: Lessons from Clinical Research

“…It is preferable to try to quantify the degree of agreement, which can be done by examining the distribution of the differences between the two methods (6). Figure 2a shows plasma values of free norepinephrine (fNE) measured in nine patients before and after dialysis (7). There is no apparent association -postdialysis values appear unrelated to pre-dialysis values.…”

Physiological aspects of pig kidney xenotransplantation and implications for management following transplant

“…64 Patients with renal failure have increased levels of free and conjugated catecholamines, but these compounds can be removed by dialysis, or a functioning kidney graft. [64][65][66] In general, humans have higher levels of free catecholamines than pigs, and a higher percentage of conjugated catecholamines. 67 However, pig kidneys can process and eliminate epinephrine and norepinephrine at acceptable rates.…”