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ORIGINAL ARTICLE
Year : 2020  |  Volume : 20  |  Issue : 2  |  Page : 91-97

Intradialytic changes in endothelin-1 level and its relation with intradialytic hypertension


1 Department of Medicine & Nephrology, Ain-Shams University, Cairo, Egypt
2 Department of Clinical Pathology, Ain-Shams University, Cairo, Egypt

Correspondence Address:
Dr. Ahmed A Emara
Department of Medicine & Nephrology, Ain-Shams University Hospitals, Cairo 11591
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jesnt.jesnt_37_19

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Background Intradialytic hypertension (IDH) is a major problem affecting 5–15% of patients with end-stage renal disease on maintenance hemodialysis (HD). We evaluated the changes of endothelin-1 (ET-1) levels during HD and its relation to IDH. Patients and methods We divided 48 stable HD patients into two groups: group I included 24 HD patients with IDH, and group II included 24 HD patients with well-controlled blood pressure (BP). Diabetic patients, patients taking angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARBs), and patients with severe infection, malignancy, or having decompensated liver cell failure were excluded from this study. For all patients, BP measurement was done before HD session and every half an hour throughout the sessions. ET-1 level was measured using enzyme-linked immunosorbent assay technique; three samples (before session, when BP rises during session, and at end of session) were taken from group I patients, and one sample was taken before the session in group II patients. Results Group I had significantly lower dry weight than group II (59.9±16 vs.71.5±11 kg) but a significantly higher ultrafiltration volume (2 vs. 1.5 l). There was a significant positive correlation between basal ET-1 and diastolic blood pressure after dialysis (r=0.51, P<0.05). In this study, basal ET-1 level had a significant moderate diagnostic performance in prediction of IDH (P< 0.001). Basal ET-1 more than or equal to 100 pg/ml had 100% specificity, 75% sensitivity, and 87.5% diagnostic accuracy in prediction of IDH, leading to suggestion that ET-1 was a significant risk factor for having IDH (P<0.05). Conclusion High ET-1 is a significant risk factor for having IDH, and basal ET-1 level had a significant moderate diagnostic performance in prediction of IDH.


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