Angiotensin-II and endothelin-1 levels in children with renoprival hypertension

Children with end-stage renal disease (ESRD) often remain hypertensive despite bilateral nephrectomy and aggressive fluid removal on hemodialysis. We speculated that an extrarenal source of renin might contribute to the release of "tissular" angiotensin-II (AT-II) generating hypertension i...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2001-06, Vol.16 (6), p.493-496
Main Authors: SEGUIAS, Luis, ZILLERUELO, Gaston, STRAUSS, Jose, ABITBOL, Carolyn, MONTANE, Brenda
Format: Article
Language:English
Subjects:
Adolescent
Age
Angiotensin II - blood
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure
Cardiology. Vascular system
Child
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Diastole
Endothelin-1 - blood
Female
Hemodialysis
Humans
Hypertension
Hypertension - blood
Hypertension - complications
Hypertension - physiopathology
Kidney diseases
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - surgery
Kidney Failure, Chronic - therapy
Laboratories
Male
Medical sciences
Nephrectomy
Plasma
Postoperative Period
Renal Dialysis
Systole
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Summary:Children with end-stage renal disease (ESRD) often remain hypertensive despite bilateral nephrectomy and aggressive fluid removal on hemodialysis. We speculated that an extrarenal source of renin might contribute to the release of "tissular" angiotensin-II (AT-II) generating hypertension in anephric patients. At the same time, experimental evidence supports that peripheral AT-II vasoconstrictive effect is likely mediated by endothelin-1 (ET-1). Thus, it is conceivable that hypertension in ESRD patients may be due, in part, to a cascade involving vascular production and secretion of AT-II and ET-1. In order to establish the relationship between AT-II, ET-1, and blood pressure we performed a pilot study to measure predialysis systolic and diastolic blood pressures (SBP and DBP, respectively) and serum AT-II and ET-1 levels in 12 anephric children receiving hemodialysis. Predialysis AT-II and ET-1 levels were similar in all patients, and neither value correlated with their mean SBP or DBP. In patients with postdialysis hypertension, there was no correlation between predialysis AT-II and ET-1 plasma levels. We therefore find no evidence to suggest that vascular-mediated AT-II and/or ET-1 contributes significantly to hypertension in anephric patients.
ISSN:0931-041X
1432-198X
DOI:10.1007/s004670100579