Contribution of volume overload to the arterial stiffness of hemodialysis patients

Łukasz Czyżewski,Janusz Wyzgał,Emilia Czyżewska,Janusz Sierdziński,Łukasz Szarpak

doi:10.1080/0886022x.2017.1279552

Łukasz Czyżewski, Janusz Wyzgał + Show 3 more

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https://doi.org/10.1080/0886022x.2017.1279552

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Journal: Renal failure	Publication Date: Jan 1, 2017
Citations: 10	License type: open-access

Affiliation: Medical University of Warsaw

Abstract

Arterial stiffness is evaluated with the measurement of pulse wave velocity (PWV), while overhydration (OH) and nutritional status are evaluated with bioimpedance spectroscopy (BIS). In this study, we investigated the effect of a single dialysis session on arterial stiffness, hydration status, and laboratory parameters. The observational, cross-sectional, cohort study included 71 HD patients with mean age 64 ± 16 yrs. A Complior device was used to perform PWV measurements. The patients were examined immediately before and 15 min after a mid-week hemodialysis session. Body fluids and nutritional status were studied using a Body Composition Monitor (BCM), Fresenius Medical Care. Clinical and laboratory data were also analyzed. Multivariate regression analysis of PWV before HD showed that an OH increase of 1 L relate to a PWV parameter rise before HD of 0.523 m/s. Multivariate regression analysis of PWV after HD showed that a rise of central SBP after HD of 10 mmHg relate to a PWV increase after HD of 0.707 m/s. Our data indicate that hydration status and blood pressure may be major determinants of PWV in HD patients.

Highlights

Cardiovascular diseases (CVD) are the main cause of death (40% of mortality) among end-stage renal disease (ESRD) patients,[1,2] presumably because of advanced atherosclerosis
Arterial stiffness is evaluated with the measurement of pulse wave velocity (PWV),[3,4] while overhydration (OH) and nutritional status are evaluated with bioimpedance spectroscopy (BIS)
We investigated the effect of a single dialysis session on arterial stiffness, hydration status, and laboratory parameters

Summary

Introduction

Cardiovascular diseases (CVD) are the main cause of death (40% of mortality) among end-stage renal disease (ESRD) patients,[1,2] presumably because of advanced atherosclerosis. Arterial stiffness is evaluated with the measurement of pulse wave velocity (PWV),[3,4] while overhydration (OH) and nutritional status are evaluated with bioimpedance spectroscopy (BIS). Volume overload may constitute another CVD risk in chronic hemodialysis (HD) patients, along with age, hypertension, and atherosclerosis.[5,6] There are several studies on the subject with similar parameters being investigated. Studies show that irrespective of age, sex, and other risk factors, a 1 m/s increase of the PWV index is associated with an increase of 14% in adjusted CV and overall mortality.[13]

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