Chronic renal failure (CRF) is one of the fastest growing global and kidney abnormalities that have poor prognosis and high mortality of patients. Manifestations of chronic renal failure include various metabolic disorders, primarily growth of toxic products (urea, uric acid, creatinine, indican). CRF is characterized by endothelial dysfunction, hypertension, changes in platelet function, increased blood levels of markers of inflammation and oxidative stress, which causes dysfunction of the sympathetic division of the autonomic nervous system.
Among the risk factors of death in patients with chronic renal failure is not only an increase of levels of toxic substances in blood, and the development of cardiovascular disease, which in 59 % of cases causes death. Cardiovascular disease include both direct change of heart and kidney disease, endothelial dysfunction, increased blood pressure and the development of inflammation – the emergence nitrozo-oxidative stress and increased levels of proinflammatory cytokines.
Among the factors, that directly influence on the cardiovascular system in patients with chronic renal failure is the level of catecholamines in blood. Increased activity of the sympathetic division of the autonomic nervous system will cause increase in the allocation of catecholamines in the blood that are released into the blood from the adrenal glands.
In 37 patients with chronic renal failure, the content of catecholamines (dofamіn, noradrenalіn and adrenalіn) before and after hemodialysis was determined. Duration of dialysis was on average 4,6 ± 0,2 hours. We used methods of dialysis low flux (19 patients) and high-flux (18 patients) with the use of dialyzers with high permeability. It is shown that the concentration of norepinephrine in the plasma of patients with end-stage renal failure was significantly higher, whereas the concentration of adrenaline and dopamine does not differ from the control group. There was no statistically significant difference in the concentration of catecholamines in men and women with chronic renal failure as compared to the control group. After hemodialysis, the patients with end-stage renal failure showed decreased plasma norepinephrine concentration in comparison with its contents before the procedure. The concentrations of adrenaline and dopamine plasma randomness did not change before and after hemodialysis. With this respect, plasma concentrations of norepinephrine and dopamine, in patients with CRF receiving dialysis therapy, their content was significantly increased compared with the patients with end-stage renal failure. Conducting a session of dialysis resulted in lower plasma concentrations of norepinephrine. In our studies we noted an increased content of norepinephrine, whereas the concentration of dopamine and adrenaline statistically unchanged.
Consequently, our research shows that among the studied concentration of catecholamines noradrenaline only in the blood plasma of the patients with end-stage growing, which is one of the risk factors for complications of the cardiovascular system. Hemodialysis session reduces the concentration of norepinephrine in the plasma.
Keywords: hemodialysis, chronic renal failure, catecholamines, oxidative stress
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