Effect of sympathetic on hemodialysis and plasma renin activity hypertension

Background: The reasons for poor control of blood pressure in hemodialysis (FID) patients are not clear, while patients have achieved their desirable dry weight and excess weight are not different between the hypertensive and normotensive patients. A link between sympathetic activity and HD hyperten sion could be an alternative explanation. Patients and methods: We studied the effect of sympathetic and plasma renin-aldosterone activity of 10 hyper tensive patients, 5 men and 5 women, aged from 30 to 60 years. The results were compared to those of another 10 normotensive hemodialysis patients. Bl ood samples were taken before HD and at the end of a 4-hour HD session for plasma aldosterone (ALDO), renin activity (PRA), adrenaline and noradrenali ne determination. One month dialysis records, which includes 13 dialysis se ssions and 26 blood pressure readings for each patient were used, for pre-d ialysis and post dialysis mean arterial blood pressure (MAP) measurement. R esults: Pre-dialysis plasma adrenaline was 124.12 +/- 12.93 pg/ml vs. 121.1 2 +/- 14.71 pg/ml and plasma noradrenaline was 260.88 +/- 140.86 pg/ml vs. 138.11 +/- 122 +/- 32 pg/ml for hypertensive and normotensive patients, res pectively. Post-dialysis plasma adrenaline and noradrenaline levels were 11 9.37 +/- 8.81 pg/ml. vs. 120.62 +/- 15.35 pg/ml and 210.44 +/- 126.71 pg/ml vs. 94.88 +/- 64.05 pg/ml for hypertensive and normotensive patients, resp ectively. Pre-dialysis PRA was 8.70 +/- 6.37 ng/ml/h vs. 2.77 +/- 1.8 ng/ml /h and plasma ALDO was 457.07 +/- 245.54 pg/ml vs. 197.74 +/- 87.46 pg/ml f or hypertensive and normotensive patients, respectively. Pre-MAP was 109.76 +/- 5.21 mmHg vs. 99.28 +/- 7.13 mmHg and post-MAP was 107.22 +/- 6.74 mmH g, vs. 91.61 +/- 7.27 mmHg for hypertensive and normotensive patients, resp ectively. Plasma ALDO and fluid volume removed by ultrafiltration were foun d to be significantly correlated (p < 0.05). PRA and plasma adrenaline-nora drenaline levels were not correlated with MAP or body weight alterations. C onclusions: it is suggested that sympathetic activity, as it was expressed by plasma catecholamine alterations, is not associated with hemodialysis hy pertension.