Document Detail

Hemodialysis Reduces Augmentation Index but Not Aortic or Brachial Pulse Wave Velocity in Dialysis-Requiring Patients.
MedLine Citation:
PMID:  21934301     Owner:  NLM     Status:  Publisher    
Background/Aims: Arterial stiffening characterizes the vasculature of end-stage renal disease (ESRD) patients and is a strong predictor of their cardiovascular morbidity and mortality. Previous studies evaluating the effect of hemodialysis on large artery elasticity gave contradictory results. This study aimed to investigate the impact of hemodialysis on arterial stiffness and wave reflections on chronic hemodialysis patients. Methods: A total of 51 stable ESRD patients on maintenance hemodialysis were evaluated before and after the first and second dialysis session of the week. Arterial stiffness was assessed by measuring aortic and brachial pulse wave velocity (PWV). Central arterial pressure waveform parameters were estimated by radial artery applanation tonometry. Heart rate-adjusted augmentation index [AIx(75)] was used as measure of wave reflections. Results: During both dialysis sessions systolic blood pressure (SBP) and pulse pressure (PP) at brachial artery and central aorta were reduced. AIx(75) was decreased in first and second weekly dialysis session (27.5 ± 1.2 vs. 21.0 ± 1.5, p < 0.001 and 24.7 ± 1.2 vs. 20.5 ± 1.5, p < 0.001, respectively). In contrast, aortic and brachial PWV remained unchanged during both dialysis sessions. Changes in AIx(75) during hemodialysis were associated with changes in central aortic SBP, PP and ejection duration. Conclusions: This study shows that hemodialysis does not acutely affect arterial stiffness, but reduces wave reflections from periphery. This dissociation between effects of hemodialysis on PWV and AIx(75) may reflect differential impact on large and small branches of the arterial tree.
Panagiotis I Georgianos; Pantelis A Sarafidis; Pavlos Malindretos; Pavlos Nikolaidis; Anastasios N Lasaridis
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-21
Journal Detail:
Title:  American journal of nephrology     Volume:  34     ISSN:  1421-9670     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109361     Medline TA:  Am J Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  407-414     Citation Subset:  -    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Section of Nephrology and Hypertension, First Department of Medicine, AHEPA University Hospital, Thessaloniki, Greece.
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