Long-term clinical spectrum and circulating RAS evaluation of anephric patients undergoing hemodialysis: A report of four cases and literature review
| Autor: | Yu-Mei Zhang, Wenge Li, Yamei Wang, Fangting Fu, Lin Liu, Li Zhuo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Medicine (General) medicine.medical_treatment 030232 urology & nephrology Urology Blood Pressure renin-angiotensin system 030204 cardiovascular system & hematology Kidney Nephrectomy patients clinical 03 medical and health sciences 0302 clinical medicine Endocrinology R5-920 Renal Dialysis Internal medicine Renin–angiotensin system Internal Medicine medicine Humans Anephric Aged Aged 80 and over business.industry Middle Aged Blood pressure Kidney Failure Chronic Female Original Article long term Hemodialysis business Bilateral Nephrectomy |
| Zdroj: | Journal of the Renin-Angiotensin-Aldosterone System, Vol 19 (2018) Journal of the Renin-Angiotensin-Aldosterone System: JRAAS |
| ISSN: | 1752-8976 |
| Popis: | Introduction: Bilateral nephrectomy leads to a short-term reduction in blood pressure. This is mainly due to a sharp change in the circulating renin-angiotensin system (RAS), but data on the long-term outcomes of their clinical status and further changes in circulating RAS are rare. Materials and methods: We enrolled four Chinese patients who had both of their kidneys removed two (1), six (1) and eight (2) years prior to this study, respectively. Their clinical data were collected retrospectively and circulating RAS was evaluated by radioimmunoassay. Results: Hypotension after surgery occurred in two patients who suffered thrombosis of the arteriovenous fistula, but no life-threatening complications occurred. The average hemoglobin level was 103.3±12.3 g/l. Two patients without hemorrhage received intravenous erythropoietin (EPO) of 4500–8000 iu/week. Extremely low plasma renin activity (PRA) of 0.08±0.03 ng/ml (normal range 0.93–6.56 ng/ml) showed in the patients. Surprisingly, plasma angiotensin II concentration (71.37±8.28 pg/ml) and aldosterone level (0.17±0.02 ng/mlng/ml) were within the normal range. Conclusions: The four anephric individuals did not suffer life-threatening complications while their hypotension gradually subsided and their EPO dosage was relatively low. Although their PRA level was extremely low, they produced normal levels of angiotensin II and aldosterone in plasma, which indicates the kidney-independent mechanism of angiotensin II production likely compensated in the long term. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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