만성 신부전 환자에서 Catecholamine 의 제거율

The adrenergic system interacts with a vaiety of tissues and organs, including the kidney. However, there is little known about the renal clearance of catecholamine (CAs) in man. To obtain this information, 4 normal subjects and 6 patients with chronic renal failure (CRF) were studied. Plasma and urinary CAs concentrations were measured by high performance liquid chromatography with an electrochemical detector. Plasma CAs concentrations (pg/ml) were norepinephrine (NE) 44.62±83.29 (pg/ml) end DOPAC 585.58±462.47 in normal subjets, and NE 632.20±290.40 and DOPAC 990.55±69.05 in CRF. Plasma CAs concentrations of the CRF group were higher than those of normal subjects, but did not differ significantly among the groups (p<0.05). Urinary CAs excretion amounts were NE 59.3±34.9 (pg/ml), E 11.9±10.2. DOPAC 27.l±61.4, and dopamine 13.4±11.2 in normal subjects, and NE 100.0±90.1, E 135.5±147.4, DOPAC 401.7±500.7, and dopamine 163.9±115, 7 in CRF. Urinary CAs and CAs clearance levels were lower in the CRF group than in normal subjects, but did not differ significantly between the groups. It is concluded that a chronic reduction in excretory kidney function may have no relevant impact on circulatory levels of CA per se, although their urinary excretion falls distinctly at the stage of advanced renal failure. These aspects deserve consideration when pathogenetic or diagnostic studies of catecholamines are performed in normotensive or hypertensive patients with impaired kidney function.