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Title: Intradialytic hypotension: beyond hemodynamics
Authors: Hajal, J
Joubran, Najat
Sleilaty, G
Chacra, D
Saliba, Y
Assaad, Joseph 
Chelala, D
Fares, N
Affiliations: Faculty of Medicine 
Keywords: Collectrin
Endothelial dysfunction
Intradialytic hypotension
Vascular Endothelial Growth Factor C
Issue Date: 2019
Part of: Physiological Research
Volume: 68
Issue: 5
Start page: 793
End page: 805
Intradialytic hypotension is a major complication during hemodialysis session, associated with increased risk of cardiovascular events and mortality. Its pathophysiology is believed to be multifactorial and remains not well elucidated. The aim of this study is to put forward new mechanisms behind the development of intradialytic hypotension. The study included sixty-five subjects on chronic hemodialysis, divided into two groups: intradialytic hypotensive (n=12) and normotensive (n=53), according to the variation of systolic blood pressure between post-dialysis and pre-dialysis measurements. Renin and angiotensin converting enzyme I plasma concentrations increased in both groups but more likely in normotensive group. Aldosterone plasma concentration is increased in the normotensive group while it decreased in the intradialytic hypotension group. Plasma endothelin concentrations showed higher values in intradialytic hypotension group. Post-dialysis asymmetric dimethylarginine and angiotensin converting enzyme 2 plasma concentrations were significantly higher in intradialytic hypotension group as compared to normotensive one. Collectrin plasma concentrations were significantly lower in intradialytic hypotension group. Finally, post-dialysis vascular endothelial growth factor C plasma concentration significantly increased in intradialytic hypotension group. In conclusion, endothelial dysfunction characterized by a lower level of vasoactive molecule seems to play a critical role in intradialytic hypotension development.
ISSN: 08628408
DOI: 10.33549/physiolres.934080
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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