Abstract
Background: Fluid removal by HD is accompanied by the modulation of circulating RASS. The present study explored changes in the RAAS hormones during HD session, analyzing factors to affect such changes. Methods: Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were measured before and after HD in 109 patients (59 diabetics and 50 non-diabetics). We then examined any association of these RAAS hormones with fluid removal, BP, the use of RAAS inhibitors, and the presence of diabetes. Results: The ratio of water removal by HD correlates with both changes in the ratio of PRA (ΔPRA) and the changes in the ratio of PAC (ΔPAC) only in patients taking RAAS inhibitors. In non-diabetics, the ratio of water removal is correlated with ΔPRA and the changes in the ratio of BP (ΔBP) is correlate with ΔPAC. However, in diabetes patients there were no such changes. The ratio of water removal has no correlation with ΔBP regardless of diabetes and the use of RASS inhibitors. Conclusion: Change in BP during HD is not associated with water removal, but is correlated with the changes in RAAS hormones. Moreover, the response of RAAS hormone to fluid removal is improved in the presence of RAAS inhibitors, suggesting that RAAS blocking modulates BP controlling mechanism in HD patients. This abnormal BP regulation may have been accelerated in the presence of diabetes.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
