Plasma Catecholamines, Renin, and Aldosterone During Hemodialysis and Hemofiltration in Children

Abstract

Although maintenance dialysis offers prolonged survival with an improved quality of life to thousands of children and adults with terminal renal disease, it is obvious that the goal of an asymptomatic treatment for end-stage renal failure has not been achieved with current dialysis techniques. Symptomatic hypotension, often accompanied by nausea and vomiting, is the most frequently encountered problem seen during routine hemodialysis today. An insufficiency of the adrenergic system has been implicated in the poor cardiovascular tolerance to hemodialysis in adults. Hemofiltration, which is based on ultrafiltration, convective transport of uremic substances across membranes of high porosity, and fluid replacement, is often better tolerated than traditional hemodialysis.