We have already reported that increase in ultrafiltrate norepinephrine (UFNE) concentration in response to hypotensive episode is found in many cases when the sequencial changes of ultrafiltrate catecholamine (UFCA) during hemodialysis is studied. The above fact suggests that sympathetic nervous system plays an important part in the change of blood pressure during hemodialysis. In the present study, we have performed high sodium concentration dialysis (HSD) on the patients suffering from dysdialysis which causes frequent hypotensive episode during dialysis, and compared the sequencial changes of UFCA in comparison to those during normal sodium concentration dialysis (NSD). Two of the 4 cases showed no difference in the response of UFCA to the decrease in blood pressure. Both showed the increase in UFCA in response to significant blood pressure fall. However, the degree of increase in UFNE was higher in HSD than in NSD. In another 2 cases. little increase in UFCA, even at the time of significant blood pressure fall, was seen with NSD, although considerable response was found with HSD. The above result indicates that the reaction of sympathetic nervous system in response to blood pressure fall is more improved during HSD than during NSD, which suggests HSD as a better therapy leading to non-symptomatic dialysis.
