N. Iida et al., TREATMENT OF DIALYSIS-INDUCED HYPOTENSION WITH L-THREO-3,4-DIHYDROXYPHENYLSERINE, Nephrology, dialysis, transplantation, 9(8), 1994, pp. 1130-1135
L-threo-3,4-dihydroxyphenylserine (L-DOPS), a precursor of noradrenali
ne (norepinephrine), which is converted into noradrenaline when orally
administered, was given orally to haemodialysed patients exhibiting d
ialysis-induced hypotension. In five patients given 300 mg L-DOPS plas
ma concentrations reached a peak of 1.43 +/- 0.59 mug/ml 6h after admi
nistration and decreased slowly to disappear after 36 h. Plasma noradr
enaline concentrations showed a significant increase (P<0.05), reachin
g a peak of 1.28 +/- 0.64 ng/ml after 24 h and declined to 0.75 +/- 0.
47 ng/ml by 48 h. Administration of L-DOPS to six patients during dial
ysis for 6 consecutive weeks showed no accumulation in the blood. Oral
administration of 200 400 mg L-DOPS to 34 patients 1 h before dialysi
s prevented dialysis-induced hypotension and decreased the number of c
oncurrent treatments required for hypotension. The signs and symptoms
of hypotension were improved in 73.5% of the patients and persisted af
ter dialysis in 64.7%. The preventive effect of L-DOPS was significant
ly more prominent in patients with predialysis systolic blood pressure
less than 100 mmHg and in patients with non-diabetic nephropathy. L-D
OPS appeared to be an effective and well-tolerated treatment for the p
revention of dialysis-induced hypotension.