PLASMA-RENIN ACTIVITY IN HEMODIALYZED PATIENTS DURING LONG-TERM FOLLOW-UP

Plasma renin activity (PRA) and mean arterial pressure (MAP) were dete rmined in 11 patients after the initiation of maintenance hemodialysis for 8 to 10 years. PRA increased significantly from 2.3 +/- 0.5 to 6. 5 +/- 1.3 ng/mL/h, whereas MAP was lowered during follow-up, and there was a strong correlation between these two (r = 0.88, P < 0.001). Imm ediately before initiating hemodialysis, PRA was negatively correlated with the increase in PRA (r = 0.62, P < 0.05) and positively correlat ed with the reduction in MAP (r = 0.65, P < 0.05). PRA was elevated an d MAP was markedly reduced in patients whose PRA was relatively low im mediately before initiating hemodialysis, whereas PRA tended to be red uced and MAP was unchanged in patients with higher levels of PRA. Thes e data suggest that renin secretion continues even after disuse atroph y of the kidneys with almost complete deterioration of its excretory f unction. (C) 1995 by the National Kidney Foundation, Inc.