Article Text

Relationship between A2A Adenosine Receptor Expression and Intradialytic Hypotension during Hemodialysis
  1. Philippe Giaime,
  2. Louis Carrega,
  3. Emmanuel Fenouillet,
  4. Laurence Mercier,
  5. Victoria Gerolami,
  6. Jean Ruf,
  7. Nicole Sauze,
  8. Philippe Brunet,
  9. Alain Saadjian,
  10. Yvon Berland,
  11. Bertrand Dussol,
  12. Regis Guieu
  1. From the Service de Néphrologie et d'Hémodialyse (P.G., P.B., B.D.), Hôpital de la Conception, Marseille, France; Laboratoire d'Ingenierie des Protéines (P.G., L.C., E.F., N.S., A.S., R.G.), FRE 2738 CNRS/Université de la Méditerranée, Marseille, France; Laboratoire de Biochimie et de Biologie Moléculaire (L.C., V.G., R.G.), Marseille, France; Faculté de Médecine (L.M., J.R.), INSERM UMR 555, Marseille, France; Service de Cardiologie (A.S.), Hôpital Nord, Marseille, France; Université de la Méditerranée, Nephrology Department (Y.B.), Marseille, France; Centre d'Investigation Clinique (Y.B.), Hôpital Sainte Marguerite, Marseille, France.
  1. This study was supported by Centre National de la Recherche che Scientifique (CNRS) and Assistance Publique des Hopitaux de Marseille (AP-HM), Marseille, France.
  2. Address correspondence to: Dr. R. Guieu, Laboratoire de Biochimie, CHU Timone Bd J Moulin, 13005 Marseille, France; e-mail: guieu.regis{at}


Background Intradialytic hypotension (IDH) is a common complication of hemodialysis sessions (HDSs). Adenosine may contribute to the drop in blood pressure during IDH events because it has hypotensive effects. As A2A adenosine receptor expression is essential for blood pressure control, we compared the expression of A2A receptors (Bmax, KD, and messenger ribonucleic acid [mRNA] levels) in peripheral blood mononuclear cells from IDH and non-IDH patients and from controls. We also evaluated adenosine plasma levels (APLs).

Methods We included 10 hemodialyzed patients with at least three IDH events per month. We also included 11 hemodialyzed patients with no history of IDH events and 10 healthy subjects as controls.

Results IDH patients had higher Bmax values than non-IDH patients (mean before HDS, +86%; after HDS, +112%), whereas non-IDH patients had lower Bmax values than controls (mean −72%). KD values were not significantly different between patients and controls. The levels of mRNA increased significantly during HDS but without an increase in receptor expression on the cell membranes. APLs were higher in hemodialyzed patients than in controls.

Conclusion We found that A2A receptors are more expressed in IDH patients than in non-IDH patients, whereas APL was high in all patients. Both high APL and a relative increase in A2A receptor expression may favor IDH events.

Key words
  • adenosine
  • A2A receptor
  • intradialytic hypotension

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.