The role of endothelin-1 in intradialytic hypertension

Abstract

Objectives To evaluate the role of endothelin-1 (ET-1) in intradialytic hypertension (IDH). Background The etiology and pathogenesis of hemodialysis (HD)-induced hypertension remains complex and speculative. There is mounting evidence that ET-1 may play a vital role in IDH. Patients and methods This is a case–control study on 84 individuals including 56 end-stage renal disease patients on regular HD and 28 normal individuals. The patients were divided into three groups. Group I (cases group): 28 patients with IDH, group II (HD control group): 28 patients with well-controlled blood pressure and no history of IDH throughout HD, and group III (healthy control group): 28 healthy volunteers. Results The mean age in this study was 50.1 years in group I, 57.1 years in group II, and 34.7 years in group III. Mean arterial pressure (MAP) significantly increased during dialysis in group I and significantly decreased in group II. Delta MAP started to increase more than or equal to 15 mmHg, that is IDH, 2 h after the start of HD session. Mean ET-1 level in group I was 281.8 pg/dl and in group II it was 250.5 pg/dl. There was significant positive correlation between ET-1 level after 2 h of starting of HD session and MAP and delta MAP. Conclusion ET-1 is a significant risk factor for having IDH.