Arterial compliance in patients on long-treatment-time dialysis

Abstract

Arterial compliance is found to be reduced in haemodialysis patients. It is not clear whether decreased arterial compliance in uraemic patients is a consequence of long-standing increased mean arterial blood pressure or a consequence of the uraemic state. An adequate blood pressure can be achieved by long-treatment-time dialysis of 8 h three times a week. We studied femoral and carotid artery wall properties in 24 normotensive patients on long-treatment-time dialysis and 24 normal controls matched for mean arterial pressure, age, sex, and body mass index. Arterial distensibility coefficient and compliance coefficient were determined with a vessel wall movement detector system, 24 h after dialysis in the supine position. The patients were 5.9 +/- 6.6 years on long-treatment-time dialysis at a Kt/V of 1.8 +/- 0.4. We found no significant differences in mean arterial pressure or pulse pressure between patients (85 +/- 13, 55 +/- 17 mmHg) and controls (84 +/- 6, 50 +/- 13 mmHg). Femoral distensibility coefficient and compliance coefficient were lower in patients (6.0 +/- 2.4 10(-3)/kPa; P < 0.05, 0.52 +/- 0.28 mm2/kPa; n.s.) compared to the controls (8.8 +/- 4.0 10(-3)/kPa, 0.67 +/- 0.38 mm2/kPa). No differences in carotid distensibility coefficient and compliance coefficient were found between patients (12.8 +/- 4.6 10(-3)/kPa, 0.72 +/- 0.30 mm2/kPa) and controls (14.1 +/- 4.4 10(-3)/kPa, 0.70 +/- 0.23 mm2/kPa). We conclude that patients on long-treatment-time-dialysis have an increased stiffening of the muscular femoral artery but not of the more elastic carotid artery. Results suggest that the uraemic state itself has a deleterious effect on the elastic properties of the muscular femoral artery.

The Relation Between Hypoalbuminemia and Compliance and Intima-media Thickness of Carotid Artery in Continuous Ambulatory Peritoneal Dialysis Patients

“…This finding that factors other than blood pressure per se affect arterial wall compliance is consistent with findings of the Tassin population study showing that arterial compliance was lower in long-term normotensive hemodialysis patients (27). …”

Arterial stiffness and pulse pressure in CKD and ESRD

“…The most characteristic arterial change observed in ESRD patients is the so-called 'accelerated arterial aging', typified by outward remodeling and arterial stiffening 11,12,[142][143][144][145][146][147][148][149] ( Figures 5 and 6). Their age-related hardening is much more pronounced in the aorta and central arteries than in muscular-type peripheral arteries 11,28,143,150 responsible for accelerated reduction of the impedance mismatch and diminished buffering capacity to lower pulsatile pressure transmission to the peripheral microcirculation ( Figure 3).…”

Salt and Hypertension in End-Stage Renal Disease

“…Despite judicious salt restriction, concentric left ventricular hypertrophy and a reduced arterial compliance were also present in strictly normotensive dialysis patients, like the Tassin population [68]. In this aspect, the uremic state itself, anemia, the presence of an arteriovenous fistula, hyperparathyroidism, and overactivities of the RAAS and sympathetic nervous system have been implicated [61].…”