Methods: Audit of medical records for (1) 58 patients who received ACP (2010–2012) and (2) 58 age and gender matched control patients (2007–2009). Results: The rate of withdrawal from dialysis was significantly higher in the implementation Torin 1 solubility dmso group (IG) (P = 0.022), as was the involvement

of the patient or family in the decision to withdraw dialysis (P = 0.001). Medical decisions to withdraw dialysis was equal between groups (P > 0.05) More ACP documents were completed in the IG (MEPOA = 67%, SOC = 27%, RTC = 17%) compared to the control group (MEPOA = 5%, SOC = 10%, RTC = 2%). Significantly more wishes were correctly documented in the IG (P < 0.001) and more changes to patient management plans were observed (71%). Patients in the IG were more likely to have their wishes respected (P = 0.007) and receive treatment in their best interest (P < 0.001). Discussion: The implementation of ACP led to patient wishes being documented and respected, and to dialysis being withdrawn at learn more the patient’s or family’s request. No difference

observed in the involvement of the medical team. More wishes were respected in the IG and more patients received treatment that was in their best interest. Conclusion: Facilitated ACP successfully increased the likelihood of wishes being respected and patients receiving treatment in their best interest. 183 THE ROLE OF THE VASODILATOR R-A-A SYSTEM IN HYPERTENSIVE PREGNANCY F PETTIT1, J SPAAN1, GJ MANGOS1,2, G DAVIS3, A HENRY3, M BROWN1,2 1Department of Renal Medicine St George Hospital Sydney; 2Department of Medicine University of New South Wales; 3Department of Women’s and Children’s Health St George Hospital Sydney, Australia Aim: To examine the activity of the ACE2/Ang(1–7) axis of the RAAS in normal and hypertensive pregnancy. Background: A novel vasodilatory pathway of the RAAS has been described,

including the angiotensin converting enzyme 2 (ACE2) and the vasodilator Ang(1–7). The pressor effects of Angiotensin-II (Ang-II) are reduced in normal pregnancy, and partially restored in pre-eclampsia. This may be explained by alteration in the balance between the vasoconstrictor and vasodilator components of RAAS. Methods: Women in their 3rd trimester in a cross sectional study. There were five Tyrosine-protein kinase BLK groups: normotensive pregnancy (NP); gestational hypertension (GH); essential hypertension (EH), pre-eclampsia (PE) and non-pregnant controls (C). Each study participant had blood taken for biochemistry and haematology as well as Renin level, Aldosterone, ACE1&2, Angiotensin II and Ang(1–7). Results: 122 women have been recruited to date; NP = 20, GH = 49, EH = 15, PE = 11 and C = 27. Hormone results are available on 95 subjects. Renin levels were higher in NP-30 U/L compared to C-19 mU/L (P < 0.05). NP-30 U/L levels were significantly higher than in EH-19 mU/L and PE-17 mU/L (P < 0.05) but similar to GH-26 U/L.