Arterial hypertension is a highly frequent symptom in end-stage renal failure. This study was designed to evaluate the importance of total exchangeable sodium (NaE), plasma renin activity (PRA) and the adrenergic nervous system in the pathogenesis of high blood pressure. 86 patients were studied (26 with end-stage kidney disease and under conservative treatment and 60 on maintenance haemodialysis). Under conservative treatment a simple linear regression analysis gave a correlation coefficient of 0.794 for NaE × log. PRA against mean arterial pressure (MAP). This data suggests that before the start of the haemodialytic treatment NaE and PRA are important determinants of hypertension. In patients undergoing chronic heamodialysis the correlation between MAP and the product of NaE × log. PRA was lost. In hypertensive patients we have found indication of an increased adrenergic activity. In fact resting heart rate and two hours walking plasma catecholamines were significantly higher in hypertensive compared with normotensive patients on dialysis. A significant positive correlation was found between basal plasma noradrenaline levels and MAP in 34 patients treated with periodic haemodialysis when hypothyroid patients were excluded. Arterial hypertension is a highly frequent symptom in end-stage renal failure and occurs in over 80% of all case histories (1, 2, 3, 4, 5). This paper is a review of our experience concerned with the pathogenesis and management of hypertension in patients with chronic renal failure.
A STUDY ON INCIDENCE OF ACUTE CARDIOVASCULAR COMPLICATIONS DURING MAINTENANCE HAEMODIALYSIS OF END-STAGE RENAL FAILURE PATIENTS
