Assessment of volume status and arterial stiffness in chronic kidney disease

Abstract

Aim: There is limited information about arterial stiffness in chronic kidney disease (CKD) which is an independent risk factor for cardiovascular events. Pulse wave velocity (PWV), augmentation index (AIx) are using to determine arterial stiffness. We aimed to study PWV, AIx, volume status in patients with stage 3B-5 CKD and continuous ambulatory peritoneal dialysis (CAPD). Methods: Sixty-six stage 3B-5 CKD patients, 21 CAPD patients, 34 healthy controls were included. Pulse wave velocity, AIx, volume status was evaluated by Mobil-O-Graph Õ , and bioimpedance spectroscopy, respectively. Results: The Median PWV was 7.5 m/s in CKD, 6.2 m/s in CAPD, 5.9 m/s in healthy controls, and while PWV was found to have increased significantly in CKD patients (p ¼ 0.002), the Alx values were similar in all groups. The median extracellular fluid excess was higher in both the CKD and, CAPD patients when compared with healthy controls (1.26 and 1.21 L, respectively). Overhydration was more prevalent in CKD and CAPD patients (p50.001). Age, central systolic blood pressure, body mass index, fat mass, overhydration, CKD, eGFR were the major determinants of PWV. Conclusion: Increased PWV was found in stage 3B-5 CKD patients. Overhydration may contribute this increment.

Assessment of volume status with cardiovascular risk factors in hemodialysis patients

“…They showed that fluid accumulates during the interdialytic period and contributes to increased blood pressure (15). Overhydration, has also been linked with arterial stiffness (12) and left ventricular dysfunction (13) and is strongly associated with poor cardiovascular outcomes Consistent with the literature, our study revealed that ultrafiltration volume and overhydration frequency were positively correlated with PWv and AI. As similar, Safar ME showed that interdialytic weight gain and hypervolemia are associated with increased aortic PWV (16).…”

Acute effects of ultrafiltration on aortic mechanical properties determined by measurement of pulse wave velocity and pulse propagation time in hemodialysis patients

“…Arterial pulse wave velocity and pulse propagation time play an important clinical role in defining patients under high cardiovascular risk, such as coronary artery disease and chronic dialysis patients (9-12). Arterial pulse wave velocity is inversely correlated with pulse propagation time, depending on age, heart rate, and variation in blood pressure level, such as systolic blood pressure and pulse pressure (8, 13), as shown in our study.…”

“…Pulse wave velocity and/or arterial stiffness is well known as a predictive risk factor for cardiovascular events in patients on hemodialysis (3-6, 12, 21). However, the effect of acute hemodialysis on pulse wave velocity is conflicting.…”

Inflammatory and Angiogenic Factors Linked to Longitudinal Microvascular Changes in Hemodialysis Patients Irrespective of Treatment Dose Intensity

“…Although some studies have linked these 2 processes [57, 58], others failed to confirm this [59, 60] with some suggesting that blood pressure [61] and fluid overload [62] are more important determinants of arterial stiffness. We did not find any association between baseline levels biomarker of inflammation and vascular health and changes in PWV over a 6-month period.…”