Acute effect of hemodialysis on arterial elasticity.

BACKGROUND/AIM Reduced arterial elasticity is an independent predictor of cardiovascular mortality in patients with end-stage renal disease (ESRD). Hemodialysis (HD) treatment per se can bring additional risk factors for vascular disease. Our study was designed to determine whether a single hemodialysis session leads to an acute alteration in parameters of arterial elasticity in ESRD. MATERIALS AND METHODS In this study, 58 patients undergoing chronic hemodialysis and 29 healthy controls were enrolled. Large artery elasticity index (LAEI) and the small artery elasticity index (SAEI) were measured by applanation tonometry. The acute effect of a hemodialysis session on arterial elasticity indices was assessed by comparison of prehemodialysis and posthemodialysis determinations. RESULTS At baseline, LAEI did not differ significantly in patients compared with controls. In contrast, the SAEI was significantly lower in patients (4.1 ± 2.6 mL/mmHg x 100) than in healthy individuals (8.9 ± 3.4 mL/mmHg x 100, P < 0.05). In patients with ESRD, no significant changes in LAEI was observed after HD, but SAEI deteriorated significantly (from 4.1 ± 2.6 mL/mmHg x 100 to 3.4 ± 2.3, P < 0.05). CONCLUSION We conclude that ESRD patients face a significant reduction in SAEI, which is exacerbated by a dialysis procedure.

[1]  Y. Yılmaz,et al.  Effect of intensive statin therapy on arterial elasticity in patients with coronary artery disease , 2008, Acta cardiologica.

[2]  E. Ritz,et al.  Cardiovascular problems on hemodialysis: current deficits and potential improvement. , 2009, Clinical journal of the American Society of Nephrology : CJASN.

[3]  J. Cohn,et al.  Relationship between arterial elasticity indices and carotid artery intima-media thickness. , 2000, American journal of hypertension.

[4]  M. Emoto,et al.  Arterial stiffness predicts cardiovascular death independent of arterial thickness in a cohort of hemodialysis patients. , 2010, Atherosclerosis.

[5]  Ahsan Alam,et al.  Cardiovascular death in dialysis patients: lessons we can learn from AURORA. , 2010, Clinical journal of the American Society of Nephrology : CJASN.

[6]  Brenda W Gillespie,et al.  Predictors of early mortality among incident US hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS). , 2006, Clinical journal of the American Society of Nephrology : CJASN.

[7]  A. Guérin,et al.  Arterial structural and functional alterations in uraemia , 2005, European journal of clinical investigation.

[8]  G. London,et al.  Arterial structure and function in end-stage renal disease , 2008, Current hypertension reports.

[9]  J. Cohn,et al.  Relationship between C-reactive protein and arterial stiffness in an asymptomatic population , 2005, Journal of Human Hypertension.

[10]  H. Paşaoğlu,et al.  The impact of dialysis type on biomarkers for cardiovascular diseases. , 2011, Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir.

[11]  H. Oflaz,et al.  Endothelial function is more impaired in hemodialysis patients than renal transplant recipients , 2003, Clinical transplantation.

[12]  R. Foley,et al.  The state of chronic kidney disease, ESRD, and morbidity and mortality in the first year of dialysis. , 2009, Clinical journal of the American Society of Nephrology : CJASN.

[13]  A. Hutchison,et al.  Cardiovascular disease in patients with chronic kidney disease , 2009, Vascular health and risk management.

[14]  Y. Yılmaz,et al.  Small arterial elasticity predicts the extent of coronary artery disease: Relationship with serum uric acid. , 2009, Atherosclerosis.

[15]  T. Ikizler,et al.  Left ventricular hypertrophy and endothelial dysfunction in chronic hemodialysis patients. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[16]  B. Lindgren,et al.  Reduced small artery but not large artery elasticity is an independent risk marker for cardiovascular events. , 2003, American journal of hypertension.

[17]  M. Kals,et al.  Arterial elasticity is associated with endothelial vasodilatory function and asymmetric dimethylarginine level in healthy subjects , 2007, Scandinavian journal of clinical and laboratory investigation.

[18]  R. Townsend,et al.  Large and small artery compliance changes during hemodialysis. , 2002, American journal of hypertension.

[19]  S. Doğan,et al.  Can Aortic Elastic Parameters be Used for the Diagnosis of Volume Overload in Patients with End Stage Renal Disease , 2012, Kidney and Blood Pressure Research.

[20]  S. Sag,et al.  [The effect of hemodialysis on right ventricular functions in patients with end-stage renal failure]. , 2012, Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology.

[21]  G. London,et al.  Pathophysiology of cardiovascular disease in hemodialysis patients. , 2000, Kidney international. Supplement.

[22]  D. Goldsmith,et al.  Arterial stiffness in renal patients: an update. , 2005, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[23]  C. Gadegbeku,et al.  Hemodynamic effects of chronic hemodialysis therapy assessed by pulse waveform analysis. , 2003, American Journal of Hypertension.

[24]  G. London,et al.  Assessment and significance of arterial stiffness in patients with chronic kidney disease , 2008, Current opinion in nephrology and hypertension.

[25]  G. London,et al.  Cardiovascular disease in the dialysis population: prognostic significance of arterial disorders , 2006, Current opinion in nephrology and hypertension.