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Possible role of new pressor protein in hypertensive anephric hemodialysis patients

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An Erratum to this article was published on 31 October 2003

Abstract

Unexplained hypertension was observed in three anephric children on hemodialysis. We investigated the possible involvement of a novel hypertensive extra-renal enzyme new pressor protein (NPP), related to coagulation β-FXIIa. Currently, NPP activity can only be determined by a rat bioassay model. On study day 1, pre dialysis, patients 1, 2, and 3 were hypertensive and their plasmas raised rat systolic blood pressure (SBP) by 45, 34, and 9 mmHg, respectively. Post dialysis, patients 1 and 2 reached their estimated dry body weight and their systemic pressures dropped, while patient 3 remained hypertensive and hypervolemic. Their post-dialysis plasmas raised rat SBP by 22, 14, and 9 mmHg, respectively. On day 2, similar relationships between patient SBP, volume status, and plasma NPP-like activity in rats were observed. The characteristic rat BP responses, lack of inhibition by captopril (ruling out a renin-mediated effect), and inhibition by soybean trypsin inhibitor support co-identity with NPP. Plasma FXIIa (combined α-FXIIa and β-FXIIa) was measured by immunoassay and found to be elevated in all patients. This investigation suggests that there is high endogenous NPP activity in the plasmas of these hypertensive hemodialysis patients, it changes with SBP and fluid volume, and is a possible contributor to their hypertension. Further studies are required to examine the wider applicability of these novel findings.

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Acknowledgements

These results were presented at the American Society of Nephrology 35th Annual Meeting and Scientific Exposition, 1–4 November 2002, Philadelphia, Pa., USA, and at the American Science Meeting, 14–17 May 2003, New York, NY, USA. This study was supported by the Heart and Stroke Foundation of Ontario (HSFO) grants NA 3478 and T4136. Peter C. Papageorgiou is a recipient of an AHEPA CANADA and HCFO scholarship.

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Authors and Affiliations

  1. Division of Nephrology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada

    Rachel J. Pearl, Michael Goldman & Denis Geary

  2. Department of Physiology and Medicine, University of Toronto, Canada

    Peter C. Papageorgiou, Akis A. Amfilochiadis & Daniel H. Osmond

  3. Heart and Stroke Richard Lewar Centre of Excellence, University of Toronto, Canada

    Peter C. Papageorgiou, Akis A. Amfilochiadis & Daniel H. Osmond

  4. Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands

    Frans Boomsma

  5. Hemostasis Biology, Novo Nordisk, Maaloev, Denmark

    Rasmus Rojkjaer

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  1. Rachel J. Pearl
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  2. Peter C. Papageorgiou
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  3. Michael Goldman
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  4. Akis A. Amfilochiadis
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  5. Frans Boomsma
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  6. Rasmus Rojkjaer
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  7. Denis Geary
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  8. Daniel H. Osmond
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Corresponding author

Correspondence to Rachel J. Pearl.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00467-003-1359-y

R.J. Pearl and P.C. Papageorgiou contributed equally to this work

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Pearl, R.J., Papageorgiou, P.C., Goldman, M. et al. Possible role of new pressor protein in hypertensive anephric hemodialysis patients. Pediatr Nephrol 18, 1025–1031 (2003). https://doi.org/10.1007/s00467-003-1246-6

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  • DOI: https://doi.org/10.1007/s00467-003-1246-6

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