Role of adenosine in dialysis-induced hypotension

Toru Shinzato, Masamiki Miwa, Shigeru Nakai, Hiroyuki Morita, Hiroko Odani, Itaru Inoue, Kenji Maeda

Research output: Contribution to journalArticlepeer-review

59 Citations (Scopus)


First, this investigation showed that plasma levels of inosine, hypoxanthine, and xanthine, which are metabolites of adenosine, rose sharply when blood pressure dropped suddenly along with symptoms during a hemodialysis session (sudden hypotension), but not when it decreased gradually with eventual symptoms (gradual hypotension). Because adenosine has an action to dilate vessels, this result indicates the possibility that the increased release of adenosine would be a cause of sudden hypotension. Second, it was found that the frequency of sudden hypotension decreases with the administration of caffeine, which is an adenosine-receptor antagonist, whereas the frequency of gradual hypotension did not change. This result supports the above-mentioned hypothesis that adenosine may well be a mediator of sudden hypotension, but not of gradual hypotension. Third, our investigation demonstrated no significant differences in plasma norepinephrine level, in plasma renin activity, or in mean blood pressure between the hemodialysis session in which caffeine was administered and the session in which a placebo was given. These findings suggest that the effect of caffeine administration to prevent sudden hypotension is not mediated by the stimulation of the sympathetic nervous system or activation of the renin-angiotensin system, but by the adenosinereceptor antagonism.

Original languageEnglish
Pages (from-to)1987-1994
Number of pages8
JournalJournal of the American Society of Nephrology
Issue number12
Publication statusPublished - 06-1994
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Nephrology


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