scholarly journals Korean Red Ginseng Improves Blood Pressure Stability in Patients with Intradialytic Hypotension

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
I-Ju Chen ◽  
Ming-Yang Chang ◽  
Sheng-Lin Chiao ◽  
Jiun-Liang Chen ◽  
Chun-Chen Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Angiotensin Ii ◽  
Treatment Phase ◽  
Intradialytic Hypotension ◽  
Red Ginseng ◽  
Korean Red Ginseng ◽  
Endothelin 1 ◽  
Two Phases ◽  
Group B ◽  
Active Treatment Phase

Introduction. Intradialytic hypotension (IDH) is a common complication during hemodialysis which may increase mortality risks. Low dose of Korean red ginseng (KRG) has been reported to increase blood pressure. Whether KRG can improve hemodynamic stability during hemodialysis has not been examined.Methods. The 8-week study consisted of two phases: observation phase and active treatment phase. According to prehemodialysis blood pressure (BP), 38 patients with IDH were divided into group A (BP ≥ 140/90 mmHg,n= 18) and group B (BP < 140/90 mmHg,n= 20). Patients were instructed to chew 3.5 gm KRG slices at each hemodialysis session during the 4-week treatment phase. Blood pressure changes, number of sessions disturbed by symptomatic IDH, plasma levels of vasoconstrictors, blood biochemistry, and adverse effects were recorded.Results. KRG significantly reduced the degree of blood pressure drop during hemodialysis (P<0.05) and the frequency of symptomatic IDH (P<0.05). More activation of vasoconstrictors (endothelin-1 and angiotensin II) during hemodialysis was found. The postdialytic levels of endothelin-1 and angiotensin II increased significantly (P<0.01).Conclusion. Chewing KRG renders IDH patients better resistance to acute BP reduction during hemodialysis via activation of vasoconstrictors. Our results suggest that KRG could be an adjuvant treatment for IDH.

scholarly journals Effects of sertraline in the prevention of low blood pressure in patients undergoing hemodialysis

2019 ◽  
Vol 41 (4) ◽  
pp. 492-500
Author(s):  
Christine Zomer Zomer Dal Molin ◽  
Thiago Mamoru Sakae ◽  
Fabiana Schuelter-Trevisol ◽  
Daisson Jose Trevisol
Keyword(s):  
Blood Pressure ◽  
Placebo Group ◽  
Major Complication ◽  
Number Needed To Treat ◽  
Intradialytic Hypotension ◽  
Double Blind ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Two Phases ◽  
Intradialytic Symptoms

Abstract Introduction: Intradialytic hypotension (IDH) is a major complication of hemodialysis, with a prevalence of about 25% during hemodialysis sessions, causing increased morbidity and mortality. Objective: To study the effects of sertraline to prevent IDH in hemodialysis patients. Methods: This was a double-blind, crossover clinical trial comparing the use of sertraline versus placebo to reduce intradialytic hypotension. Results: Sixteen patients completed the two phases of the study during a 12-week period. The IDH prevalence was 32%. A comparison between intradialytic interventions, intradialytic symptoms, and IDH episodes revealed no statistical difference in the reduction of IDH episodes (p = 0.207) between the two intervention groups. However, the risk of IDH interventions was 60% higher in the placebo group compared to the sertraline group, and the risk of IDH symptoms was 40% higher in the placebo group compared to the sertraline group. Survival analysis using Kaplan-Meier estimator supported the results of this study. Sertraline presented a number needed to treat (NNT) of 16.3 patients to prevent an episode from IDH intervention and 14.2 patients to prevent an episode from intradialytic symptoms. Conclusion: This study suggests that the use of sertraline may be beneficial to reduce the number of symptoms and ID interventions, although there was no statistically significant difference in the blood pressure levels.

Chronic Synergistic Effect of Endothelin-1 and Angiotensin II on Blood Pressure in Conscious Rats

1991 ◽  
Vol 17 ◽  
pp. S514-516 ◽  
Author(s):  
Kazunori Yoshida ◽  
Minoru Yasujima ◽  
Masahiro Kohzuki ◽  
Kazuo Tsunoda ◽  
Kei Kudo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Angiotensin Ii ◽  
Synergistic Effect ◽  
Conscious Rats ◽  
Endothelin 1

Abstract P180: Effect Of Sunitinib Treatment On Skin Sodium Accumulation In Patients With Metastatic Renal Cancer: A Pilot Study

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Lajos Marko ◽  
Anne Dörr ◽  
Peter R Linz ◽  
Anton H. van den Meiracker ◽  
Titus Kühne ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Treatment Protocol ◽  
Treatment Phase ◽  
Sodium Content ◽  
Metastatic Renal Cancer ◽  
Sodium Accumulation ◽  
Endothelin 1 ◽  
Sunitinib Treatment ◽  
Pressure Changes ◽  
Tissue Sodium

Angiogenesis is required for invasive tumor growth and metastasis which is controlled mainly by vascular endothelial growth factors (VEGF). Novel strategies for cancer treatment target VEGF signaling. These agents are featured by adverse events including hypertension. New concepts suggest that besides the kidneys, the skin also plays a role in body sodium homeostasis and blood pressure regulation by a VEGF-C–dependent buffering mechanism. Here, we tested the hypothesis that changes in blood pressure correspond to tissue sodium accumulation during sunitinib treatment of metastatic renal cell carcinoma patients (https://clinicaltrials.gov/identifier: NCT04368546; Charité ethical approval EA1/044/15).Male patients (n=4) took sunitinib according to the standard treatment protocol, 50 mg once daily, taken for 4 weeks followed by a 2-weeks off treatment period. Measurements were performed at baseline (before sunitinib treatment), and over a complete on-off-on period. Tissue sodium content was measured using non-invasive 23Na-MRI; skin sodium was measured in a group (n=5) of age-matched healthy subjects, as well. Blood pressure was measured according to AHA guidelines. Blood withdrawal followed after ca. 45 minutes of sitting to measure VEGF-A, VEGF-C, endothelin-1, renin and aldosterone levels.Elevated systolic blood pressure under sunitinib treatment decreased to the baseline level in the off-treatment phase (130.5 mmHg vs 117.5 mmHg, respectively, p<0.05). Plasma endothelin-1 levels mirrored directly and VEGF-A levels inversely the blood pressure changes. Baseline skin sodium content was similar to the skin sodium level of healthy controls. Skin sodium content was elevated after the first on-treatment phase and stayed high in all the following measurements in comparison to control subjects. Patients had high baseline VEGF-C levels that decreased after the first treatment with sunitinib and stayed low independently of further treatment phase.In conclusion, sunitinib treatment suppresses VEGF-C levels permanently which is associated with sustained elevated skin sodium levels. Furthermore, we confirmed the association between plasma endothelin-1 levels and blood pressure changes during sunitinib treatment protocol.

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