Increased Nitric Oxide Production in Hypotensive Hemodialysis Patients

Nitric oxide production and blood pressure reduction during haemodialysis

“…5 Beasley and Brenner suggested that nitric oxide (NO), a potent endogenous vasodilator, caused intradialysis blood pressure reduction. 6 NO production increases significantly during HD, [7][8][9][10][11][12][13][14] resulting in significant and rapid vasodilatation and hypotension.…”

“…15 Indeed, previous studies show that plasma bs_bs_banner Nephrology 19 (2014) 562-567 total nitrate and nitrite concentration was higher in IDD patients than those without (NIDD) during dialysis. 10,14 However, only a few papers studying intradialysis blood pressure changes have measured dialysate concentrations of nitrate and nitrite at discrete time points during HD. 9 In the present study, we continuously collected partial dialysates during the entire dialysis sessions and measured total dialysate nitrate and nitrite concentrations.…”

Why are some dialysis patients chronically hypotensive in the absence of heart disease and volume depletion?

“…Nitric oxide (NO) is a potent vasodilator whose production is increased in uremia and has been implicated in the pathogenesis of chronic hypotension. When compared to those with normal BP, plasma levels of nitrites are significantly higher in chronically hypotensive patients and vary inversely with mean arterial pressure (4,8,9). Plasma levels correlate positively with the number of years on dialysis, in line with the inverse correlation between BP and time on dialysis.…”

Effects of the Intermittent Pneumatic Circulator on Blood Pressure during Hemodialysis

“…In addition, the number of episodes of hypotension that required clinical intervention was significantly reduced with the circulator intervention (P = 0.028). It is noteworthy that the circulator intervention may be also effective for the hemodialysis patient with chronic hypotension defined as SBP less than 100 mmHg in the interdialytic period [ 23 , 24 ]. One of our subjects had chronic hypotension and appeared to respond well to the intervention.…”