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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate the additive effect of moderate chronic renal failure to the abnormal dopamine generation and action observed in stable hypertension, we investigated 22 age-matched patients with a comparable degree of hypertension with and without chronic renal failure. Both groups were compared with each other and with an age-matched control group after a single oral dose of dihydroxyphenylalanine (DOPA) while cardiorenal responses and DOPA, dopamine, and their metabolites were measured. The hypertensive patients with chronic renal failure shared with their hypertensive counterparts without chronic renal failure an impaired DOPA decarboxylation to dopamine. However, patients with chronic renal failure had decreased hemodynamic and normal natriuretic responses compared with the hypernatriuresis of hypertensive patients with normal renal function; patients with chronic renal failure had elevated basal plasma concentrations of DOPA and dopamine sulfates as well as increased plasma and urinary DOPA sulfate but blunted urinary dopamine sulfate increases after DOPA administration; they presented augmented plasma atrial natriuretic factor concentrations. Thus, hypertensive patients with moderate chronic renal failure exhibit a decreased hemodynamic responsiveness to DOPA administration-induced dopamine elevation but with the natriuretic effect of dopamine maintained (possibly because of its permissive interaction with increased atrial natriuretic factor levels). Hypertensive patients with chronic renal failure have a heightened DOPA and dopamine sulfoconjugating propensity. Dopamine sulfate attenuates the biologic action of free dopamine. This may contribute (possibly via glomerular hypertension and hyperfiltration due to decreased postglomerular vasodilation) to progressive hypertensive renal damage, particularly in groups predisposed to dopamine deficiency, such as diabetics, blacks, and the elderly.
Hypertension 1994 Jan
PMID:Dopaminergic abnormalities in hypertension associated with moderate renal insufficiency. 828 67

Baseline dihydroxyphenylalanine (DOPA) and dopamine (DA), their respective sulfates as well as oral DOPA administration-induced changes were compared in age- and blood pressure-matched hypertensive patients without and with moderate chronic renal failure (CRF) and control subjects. The only common feature of both hypertensive groups was a defective DA generation from DOPA. Hypertensive patients with moderate CRF were distinct from those without, having increased basal concentrations of plasma DOPA and DA sulfates. After oral DOPA administration, plasma and urinary DOPA sulfate rose while renal DA sulfate clearance was decreased. Possible enzymatic defects contributing to CRF-induced increases of DOPA and DA sulfates and their potential role in perpetuating renal failure via glomerular hypertension are discussed.
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PMID:Dopamine deficiency--its potential contribution to chronic renal failure complicating hypertension. 852 56