Plasma Norepinephrine Predicts Survival and Incident Cardiovascular Events in Patients With End-Stage Renal Disease

• DOI: 10.1161/hc1102.105261
• Publication Date: 2002-07-28T23:16:07Z
• Authors: Carmine Zoccali; Francesca Mallamaci; Saverio Parlongo; Sebastiano Cutrupi; Francesco Antonio...; Giovanni Tripepi; Graziella Bonanno; Francesco Rapisarda; Pasquale Fatuzzo; Giuseppe Seminara; Alessandro Catali...; Benedetta Stancan...; Lorenzo Salvatore...
• Keywords: Pulse pressure

Background — Sympathetic tone is consistently raised in patients with end-stage renal disease (ESRD). We therefore tested the hypothesis that sympathetic activation associated mortality and cardiovascular events a cohort of 228 undergoing chronic hemodialysis who did not have congestive heart failure at baseline had left ventricular ejection fraction >35%. Methods Results The plasma concentration norepinephrine (NE) was used as measure activity. Plasma NE exceeded upper limit normal range (cutoff 3.54 nmol/L) 102 dialysis (45%). In multivariate Cox regression model included all univariate predictors death well use sympathicoplegic agents β-blockers, proved to be an independent predictor this outcome (hazard ratio [1-nmol/L increase NE]: 1.07, 95% CI 1.01 1.14, P =0.03). Similarly, emerged fatal nonfatal NE] 1.08, 1.02 1.15, =0.01) previous events, pulse pressure, age, diabetes, smoking, β-blockers. adjusted relative risk for complications >75th percentile 1.92 (95% 1.20 3.07) times higher than those below threshold ( =0.006). Conclusions nerve overactivity outcomes ESRD. Controlled trials antiadrenergic drugs are needed determine whether interference system could reduce high morbidity patients.