Effects of hemodialysis and saline loading on body fluid compartments, plasma renin activity and blood pressure in patients on chronic hemodialysis.
Effects of hemodialysis and saline loading on body fluid compartments, plasma renin activity and blood pressure in patients on chronic hemodialysis.
复制标题
血液透析和盐水负荷对慢性血液透析患者体液室、血浆肾素活性和血压的影响。
作者：
F. Leenen;S. J. Galla;G. G. Geyskes;H. Murdaugh;A. P. Shapiro
对7例慢性肾功能衰竭维持性血液透析患者进行一次血液透析和随后的1.5-2L N生理盐水负荷对血压、肾素A和体液室的影响。透析仅使血浆容量、ECV和TEBS轻微下降。平均血压下降5-10毫米汞柱，PRA上升30%。生理盐水负荷使血浆容量显著增加0.4升，血压增加10-5毫米汞柱，但PRA下降40%。平均血压的变化与血浆容量的变化呈正相关，与PRA的变化呈负相关。结论：慢性血液透析患者的肾素-血管紧张素系统在受到容量丢失或容量和钠负荷的挑战时，仍是循环内稳态的调节机制之一。
The influence of one hemodialysis session and of subsequent loading by 1.5-2 liters N saline on blood pressure, PRA and body fluid compartments was assessed in seven patients with chronic renal failure on maintenance hemodialysis. Dialysis caused only slight decreases in plasma volume, ECV and in TEBS. Lying mean blood pressure by 5-10 mm Hg and PRA increased by 30%. Saline loading resulted in a significant increase in plasma volume by 0.4 liters and in blood pressure by 10-5 mm Hg, but in a decrease in PRA by 40%. The changes in mean blood pressure correlated positively with the changes in plasma volume, and negatively with the changes in PRA. It is concluded that the renin-angiotensin system in patients on chronic hemodialysis still functions as one of the adjustment mechanisms for the circulatory homeostasis, when challenged by volume loss or volume and sodium loading.