1976 Volume 18 Issue 5 Pages 349-355
We studied catecholamine levels in the urine or in the ultrafiltrate extracted from the blood of the patients with chronic renal failure in order to elucidate hypertension in renal failure.1. Urinary excretion of catecholamines in these patients was found to markedly reduce. Twenty four-hour excretion of catecholamines in 7 patients without dialysis were as follows; norepinephrine (NE) : 3.5±2.1 ig/day; epinephrine (E) : 3.0±1.4 and NE +E : 6.5±1.4. Daily excretion of NE and E in 17 healthy subjects aged from 19 to 40 years were 17.8±2.8, ug/day and 7.3±1.4, respectively.2. Reduced excretion of catecholamines in these seven patients well correlated with elevated systolic blood pressure as well as increased levels of BUN. The corelation coefficients were-0.45 in systolic blood pressure and -0.74 in BUN levels using distinct reciprocal plot analysis.3. Patients treated with regular dialysis were divided into two groups : one was normotensive and the other hypertensive (above 180nmHg of systolic blood pressure). The occurrences of hypertension and elevated NE levels in the ultrafiltrate extracted from the blood of "hypertensive group" were observed to appear 48 hours after the treatment of dialysis and were not observed immediately after 4 hours dialysis. NE and E contents in the ultrafiltrate extracted from the blood of normotensive patients were 0.5±0.lpg/L and 1.1±0.2, ug/L, respectively. However NE contents in the ultrafiltrate extracted from the blood of hypertensive patients were significantly higher (NE: 3.6±1.1μ/L, E:1.4pg/L) than that of normotensive patients. There is also a significant correlation (0.84) between this NE content and systolic blood pressure. In conclusion, our results indicate that catecholamines, especially NE appear to play important role on the occurrence of hypertension in chronic renal failure.
