Apelin, plasmatic osmolality and hypotension in dialyzed patients

Blood Purif. 2012;33(4):317-23. doi: 10.1159/000337104. Epub 2012 Jun 12.

Abstract

Background/aims: To evaluate the balance between arginine-vasopressin (AVP) and apelin during hemodialysis and its role in hypotension onset and in the inflammation status.

Methods: We enrolled 50 patients chronically treated with hemodialysis. We assessed plasmatic osmolality, AVP, apelin, mean blood pressure (BP), high-sensitivity C-reactive protein (hsCRP) and β(2)-microglobulin.

Results: Apelin rises during dialytic treatment (from 0.68 ± 0.34 to 1.89 ± 0.56 pg/ml, p < 0.0001), while plasmatic osmolality (from 325 ± 4.54 to 311 ± 1.20 mosm/kg H(2)O, p < 0.0001), AVP (from 4.28 ± 1.12 to 2.48 ± 0.50 pg/ml, p < 0.0001) and mean BP (from 124 ± 6 to 110 ± 7 mm Hg, p < 0.0001) decrease. At multivariate regression with respect to apelin, only mean BP remains (r = -0.95, p < 0.0001). We also correlated the AVP/apelin ratio with BP. Moreover, apelin is inversely related to hsCRP (r = -0.79, p < 0.0001).

Conclusions: The AVP/apelin balance changes with plasmatic osmolality variations induced by hemodialytic sessions and could represent a physiopathological marker of arterial hypo- and hypertension. Finally, apelin appears inversely related to inflammation markers.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Apelin
  • Arginine Vasopressin / blood*
  • Blood Pressure
  • C-Reactive Protein / analysis
  • Cohort Studies
  • Female
  • Humans
  • Hypotension / blood*
  • Hypotension / etiology*
  • Inflammation / blood
  • Intercellular Signaling Peptides and Proteins / blood*
  • Male
  • Middle Aged
  • Osmolar Concentration
  • Plasma / chemistry
  • Renal Dialysis / adverse effects*
  • beta 2-Microglobulin / blood

Substances

  • APLN protein, human
  • Apelin
  • Intercellular Signaling Peptides and Proteins
  • beta 2-Microglobulin
  • Arginine Vasopressin
  • C-Reactive Protein