ENDOTHELIN IN PATIENTS WITH CHRONIC-RENAL-FAILURE

Hypertension, anemia, and arteriovenous shunts represent very importan t pathogenic factors in the occurrence of cardiovascular morbidity and mortality in patients with chronic renal failure. It can be expected that endothelin (ET), the most potent vasoconstrictor known at present , can react in a significant way to the hemodynamic changes caused by the construction of a vascular shunt or anemia. in 14 patients the pla sma ET concentration was examined before and 24 h and 7 days after the construction of arteriovenous fistula. In 27 patients undergoing chro nic hemodialysis treatment, ET was examined before the erythropoietin (EPO) therapy and after 2 months of EPO therapy, when partial correcti on of anemia had been achieved. The construction of arteriovenous fist ula by itself had no significant influence on the plasma ET concentrat ion. Subcutaneous application of EPO in doses that led to gradual corr ection of anemia was not accompanied by the rise of plasma ET The aver age plasma concentration of ET was significantly higher in hemodialyze d patients, when compared to healthy controls as well as to patients w ith chronic renal failure before hemodialysis treatment was started.