Acute effect of hemodialysis on arterial elasticity
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 × 100) than in healthy individuals (8.9 ± 3.4 mL/mmHg × 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 × 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.
Acute effect of hemodialysis on arterial elasticity
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 × 100) than in healthy individuals (8.9 ± 3.4 mL/mmHg × 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 × 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.
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- Meeus F, Kourilsky O, Guerin AP, Gaudry C, Marchais SJ, London GM. Pathophysiology of cardiovascular disease in hemodialysis patients. Kidney Int Suppl 2000; 76: 140–147.
- Guérin AP, Pannier B, Métivier F, Marchais SJ, London GM. Assessment and significance of arterial stiffness in patients with chronic kidney disease. Curr Opin Nephrol Hypertens 2008; 17: 635–641.
- Guérin AP, Pannier B, Marchais SJ, London GM. Cardiovascular disease in the dialysis population: prognostic significance of arterial disorders. Curr Opin Nephrol Hypertens 2006; 15: 105– 110.
- Covic A, Gusbeth-Tatomir P, Goldsmith DJ. Arterial stiffness in renal patients: an update. Am J Kidney Dis 2005; 45: 965–977.
- Shoji T, Maekawa K, Emoto M, Okuno S, Yamakawa T, Ishimura E, Inaba M, Nishizawa Y. Arterial stiffness predicts cardiovascular death independent of arterial thickness in a cohort of hemodialysis patients. Atherosclerosis 2010; 210: 145–149.
- Fazlioğlu M, Sentürk T, Kumbay E, Kaderli AA, Yilmaz Y, Ozdemir B, Baran I, Aydinlar A. Small arterial elasticity predicts the extent of coronary artery disease: relationship with serum uric acid. Atherosclerosis 2009; 202: 200–204.
- Akgullu C, Ozdemir B, Yilmaz Y, Kazazoglu AR, Aydinlar A. Effect of intensive statin therapy on arterial elasticity in patients with coronary artery disease. Acta Cardiol 2008; 63: 467–471.
- Gadegbeku CA, Shrayyef MZ, Ullian ME. Hemodynamic effects of chronic hemodialysis therapy assessed by pulse waveform analysis. Am J Hypertens 2003; 16: 814–817.
- Duprez DA, Somasundaram PE, Sigurdsson G, Hoke L, Florea N, Cohn JN. Relationship between C-reactive protein and arterial stiffness in an asymptomatic population. J Hum Hypertens 2005; 19: 515–519.
- Cohen DL, Townsend RR. Large and small artery compliance changes during hemodialysis. Am J Hypertens 2002; 15: 236– 239.
- Grey E, Bratteli C, Glasser SP, Alinder C, Finkelstein SM, Lindgren BR, Cohn JN. Reduced small artery but not large artery elasticity is an independent risk marker for cardiovascular events. Am J Hypertens 2003; 16: 265–269.
- Kals J, Kampus P, Kals M, Teesalu R, Zilmer K, Pulges A, Zilmer M. Arterial elasticity is associated with endothelial vasodilatory function and asymmetric dimethylarginine level in healthy subjects. Scand J Clin Lab Invest 2007; 67: 536–544.
- Yildiz A, Oflaz H, Pusuroglu H, Mercanoglu F, Genchallac H, Akkaya V, Ikizler TA, Sever MS. Left ventricular hypertrophy and endothelial dysfunction in chronic hemodialysis patients. Am J Kidney Dis 2003; 41: 616–623.
- Miyazaki H, Matsuoka H, Itabe H, Usui M, Ueda S, Okuda S, Imaizumi T. Hemodialysis impairs endothelial function via oxidative stress: effects of vitamin E-coated dialyzer. Circulation 2000; 101: 1002–1006.
- Oflaz H, Pusuroglu H, Genchallac H, Demirel S, Bugra Z, Sever MS, Yildiz A. Endothelial function is more impaired in hemodialysis patients than renal transplant recipients. Clin Transplant 2003; 17: 528–533.
- Duprez DA, De Buyzere ML, De Backer TL, Van De Veire N, Clement DL, Cohn JN. Relationship between arterial elasticity indices and carotid artery intima-media thickness. Am J Hypertens 2000; 13: 1226–1232.
- Sayin MR, Akpinar I, Cetiner MA, Karabag T, Aydin M, Hur E, Dogan SM. Can aortic elastic parameters be used for the diagnosis of volume overload in patients with end stage renal disease. Kidney Blood Press Res 2012; 36: 268–277.