Nitric oxide production and blood pressure reduction during haemodialysis

Chang, Chiz‐Tzung; Chien, Ming-Hui; Yang, Kai-Liang; Yu, Chien‐Chih; Hsu, Jing‐Fang; Wang, I‐Kuan; Paik-Seong, Lim; Huang, Chiu‐Ching

doi:10.1111/nep.12280

Cited by 8 publications

(5 citation statements)

References 33 publications

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“…for the development and progression of cardiovascular disorders in the case of DN is important not only to determine the role of CKD in the cardiovascular continuum, but also to develop new approaches to modern preventive nephrology. Today in the solution of the problem of ultrahigh frequency of coronary catastrophes, cardiac arrhythmias, cerebrovascular complications, congestive heart failure and sudden death in patients with type 2 diabetes with renal impairment in HD more and more importance is given to the study of chronic inflammation and ED[15, 16], because proinflammatory mediators and damaged endothelial cells are not only markers of DN progression with a negative impact on the prognosis, but also independent factors of increased cardiovascular risk[17,18, 19].In this study, DN in patients with CKD VD stage is combined with the activation of systemic manifestations of inflammationthe accumulation of CRP, TNF-ɑ, FG, which echoes the work of many authors[7,8,20] who observed cytokine aggression in case of DM and programmed HD. At the same time Hsu et al[5] do not find differences in the intensity of inflammatory process between groups of HD patients with and without DN, and Avci et al[4] report on inhibition of cellular inflammatory activity against OS under these conditions.…”

supporting

confidence: 73%

Cardiovascular Features of Chronic Inflammation and Endothelial Dysfunction in Patients with Diabetic Nephropathy on Programmed Hemodialysis

Litovkina

Susla

2020

J Educ Health Sport

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Introduction and purpose: It is important today to determine the factors that form a very high cardiovascular risk in patients with type 2 diabetes mellitus (DM) with kidney damage on programmed hemodialysis (HD). The aim of the study has been to determine the cardiovascular features of chronic inflammation and endothelial dysfunction (ED) in HD patients with diabetic nephropathy (DN). Material and methods: The study has included 136 patients treated with HD (men, 78; age, 53.9±1.0 year, duration of HD, 47.6±4.2 months). Depending on the presence/absence of type 2 diabetes, they have been divided into two groups: the firstwithout DN (n=88); the secondwith DN (n=48). The intensity of inflammation has been assessed by the serum content of tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), fibrinogen (FG) and albumin. Vasomotor function of the brachial artery (BA) has been determined using a test with reactive hyperemia (endothelium-dependent vasodilation, (EDVD)). The content of nitrite anions (NO2-) and the number of circulating endothelial cells (CECs) in blood plasma have been measured. Results: In patients with DN, TNF-α (p=0.002), CRP (p<0.001) and FG (p=0.008) significantly exceeded those in non-diabetics. The average value of EDVD BA (p=0.001), NO2-(p=0.008) in patients of the second group has been lower, and the number of 145 CECshigher (p<0.001) compared with the first group. Vasoconstriction (EDVD<0%) and undilatation (EDVD=0%) reactions in the case of DN have been registered more often (52.1 vs. 19.1%, p<0.001). In patients with DN for the first time have been established correlations between CECs and TNF-α (Rs=0.73, p<0.001), CRP (Rs=0.53, p<0.001), FG (Rs=0.53, p<0.001), albumin (Rs=-0.43, p=0.002). Conclusions: Chronic inflammation in the constellation with endothelial damage in patients with DN in the case of HD is obviously an important factor in cardiovascular remodeling, a predictor of progression of cardiovascular complications.

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supporting

confidence: 73%

Cardiovascular Features of Chronic Inflammation and Endothelial Dysfunction in Patients with Diabetic Nephropathy on Programmed Hemodialysis

Litovkina

Susla

2020

J Educ Health Sport

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“…Activating the endothelial nitric oxide synthase (eNOS) in the vascular endothelial cells will promote the synthesis and release of NO which can penetrate the cell membrane and diffuse to the adjacent smooth muscle cells. In the smooth muscle cells, NO binds to the Fe 2+ which is the hemoglobin component of the guanylate cyclase followed by elevating the cGMP levels, activating the protein kinase, phosphodiesteric acid, and ion channels, resulting in the vessel smooth muscle relaxation and vasodilatation, and increasing blood perfusion (BP) [ 12 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Electroacupuncture Stimulation at “Zusanli” Acupoint on Hepatic NO Release and Blood Perfusion in Mice

Wang

Zhang

Tang

et al. 2015

Evidence-Based Complementary and Alternative Medicine

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The study is to observe the influence of electroacupuncture (EA) stimulation at “Zusanli” (ST36) on the release of nitric oxide (NO) and blood perfusion (BP) in the liver and further explore whether the hepatic blood perfusion (HBP) changes were regulated by EA ST36 induced NO in nitric oxide synthase inhibited mice. The HBP change of the mice was detected by laser speckle perfusion imaging (LSPI) before and after being given interventions, and the NO in liver tissue was detected by nitric acid reductase in each group. The NO levels and HBP in the L-NAME group were significantly lower than those in the control group (P < 0.01). The NO level and HBP increase in EA group were significantly higher than those in control group (P < 0.05). The NO level in the L-NAME EA group was slightly higher than that in the L-NAME group. The HBP increase in the L-NAME EA group was not statistically significant. These results showed that EA could accelerate the synthesis of NO and thereby increase HBP via vasodilation in liver tissue.

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“…Although NO is a small, easily diffusible molecule by the dialysis membrane, its levels significantly increase during HD [ 34 ]. High blood NO levels are associated with hyperactivation of macrophage activity by both uremia and HD procedure itself [ 32 ].…”

Section: Immunological Dysfunction In Hdmentioning

confidence: 99%

“…Derangement and dysregulation of thymus functions in ESRD patients could reflect the reduction of naive T cells [ 55 ]. Further, IDO1 activity and NO formation also contribute to T-cell immunosuppression and Treg activation [ 33 , 34 ]. The pivot of uremic toxins in promoting endothelial dysfunction and thereby vascular complications has recently re-emerged.…”

Section: Immunological Dysfunction In Hdmentioning

confidence: 99%

Enhancing Immune Protection in Hemodialysis Patients: Role of the Polymethyl Methacrylate Membrane

et al. 2023

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End-stage renal disease (ESRD) is characterized by deep disorders in both innate and adaptive immune systems that imply unbalance deactivation and immunosuppression. The central, widely recognized factors responsible for this immune dysregulation are uremia, uremic toxin retention, hemodialysis membrane biocompatibility, and related cardiovascular complications. Recently, several studies strengthened the concept that dialysis membranes are not considered as a simple diffusive/adsorptive device but as a platform to personalize a dialysis approach to improve the quality of life of ESRD patients. Therefore, understanding of the molecules associated with altered immune response is crucial and could lead to therapeutically intervention or adaptation of the dialysis procedure itself for the management of immunological dysfunction of ESRD patients. The polymethyl methacrylate (PMMA)-based membrane is characterized by a symmetrical structure with large-sized pores, providing a better hydrophobic and cationic adsorption capacity compared to the other synthetic membranes. Together with hydrophobic interactions, the high adsorption rate of cytokines (i.e., IL-6) can also be enhanced by the size of nano-pores placed on the membrane surface. PMMA membranes exhibit adsorptive properties for a large amount of uremic toxins including p-cresol and indoxyl sulfate, as well as β2-microglobulin characterized by higher molecular weight, maintaining the diffusive clearance of small molecules like urea with a great biocompatibility. Besides exerting a strong anti-inflammatory effects in line with the improvement of immune responses in patients undergoing dialysis, PMMA also plays a role in modulating adaptive immune response, i.e., can clear blood from soluble CD40, a natural antagonist of the CD40/CD40L signaling that acts inhibiting immunoglobulin production by B cells. This review provides an overview of the main concepts and current understanding of immune dysfunction in hemodialysis and summarizes the recent findings regarding PMMA-based dialysis as potential strategy to restore immune balance in ESRD patients.

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Nitric oxide production and blood pressure reduction during haemodialysis

Cited by 8 publications

References 33 publications

Cardiovascular Features of Chronic Inflammation and Endothelial Dysfunction in Patients with Diabetic Nephropathy on Programmed Hemodialysis

Cardiovascular Features of Chronic Inflammation and Endothelial Dysfunction in Patients with Diabetic Nephropathy on Programmed Hemodialysis

Effects of Electroacupuncture Stimulation at “Zusanli” Acupoint on Hepatic NO Release and Blood Perfusion in Mice

Enhancing Immune Protection in Hemodialysis Patients: Role of the Polymethyl Methacrylate Membrane

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