Document Detail

Hemodynamic effects of chronic hemodialysis therapy assessed by pulse waveform analysis.
MedLine Citation:
PMID:  14553959     Owner:  NLM     Status:  MEDLINE    
Cardiovascular responses to hemodialysis have been characterized by invasive monitoring techniques. These techniques are not feasible for evaluation of hemodynamic status during dialysis in the outpatient setting. In this study, we used pulse waveform analysis (PWA), a noninvasive tool designed for the ambulatory setting, to assess hemodynamic responses of dialysis treatments in 27 stable subjects with end-stage renal disease receiving chronic hemodialysis. In our population, systolic, diastolic, and pulse pressures were unaffected by dialysis despite the mean fluid removal of 3.0 +/- 0.2 kg. However, using PWA, we observed that stroke volume and cardiac output progressively declined by 17% to 19% (P <.001) with a concomitant increase in systemic vascular resistance by 22% from 1654 +/- 88 to 2020 +/- 121 dynes. sec. cm(-5) (P <.001). Also, we observed a significant reduction in small artery compliance from 4.7 +/- 0.5 to 3.3 +/- 0.4 mL. mm Hg(-1). 100 (P =.01), whereas large artery elasticity was unaffected. These findings suggest that changes in small artery vascular compliance contribute to the elevation in systemic vascular resistance during dialysis. This study confirms that hemodynamic adaptations to the dialysis procedure can be detected using PWA and are consistent with data obtained by invasive monitoring techniques. Furthermore, the observed reduction in vascular compliance in response to dialysis may contribute to the high cardiovascular risk in patients undergoing chronic hemodialysis therapy.
Crystal A Gadegbeku; M Zakarea Shrayyef; Michael E Ullian
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of hypertension     Volume:  16     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-13     Completed Date:  2004-02-26     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  814-7     Citation Subset:  IM    
Department of Medicine, Medical University of South Carolina, Charleston, South Carolina 29436, USA.
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MeSH Terms
Aged, 80 and over
Blood Pressure*
Cardiac Output
Kidney Failure, Chronic / physiopathology*,  therapy*
Middle Aged
Renal Dialysis*
Grant Support

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