Changes in arterial stiffness following dialysis in relation to overhydration and to endothelial function

Hogaş, Simona; Ardeleanu, Serban; Segall, Liviu; Şerban, Dragomir Nicolae; Șerban, Ionela Lăcrămioara; Hogaș, Mihai; Apetrii, Mugurel; Onofriescu, Mihai; Sascău, Radu Andy; Covic, Adrian

doi:10.1007/s11255-011-9933-x

Cited by 17 publications

(27 citation statements)

References 50 publications

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“…The AIx, PP, and PWV are the most important indicators of arterial stiffness. The studies that evaluated the effect of hemodialysis session on various arterial stiffness parameters have yielded different results …”

Section: Discussionmentioning

confidence: 99%

“…The studies in the literature have designed to measure PWV before and at the end of the dialysis session . There is no study in the literature that evaluated the changes in PWV and AIx during the dialysis session.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies reported no improvement in PWV and AIx after correction of the volume load by ultrafiltration . Another study reported partial and short‐term favorable effects of hemodialysis and volume control on the PWV and AIx . During hemodialysis, activation of the adrenergic system and renin system and production of nitric oxide were suggested to influence arterial stiffness …”

Section: Introductionmentioning

confidence: 99%

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The effects of single hemodialysis session on arterial stiffness in hemodialysis patients

Öğünç

Akdam

Alp

et al. 2015

Hemodialysis International

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Increased arterial stiffness in hemodialysis patients is a strong predictor of cardiovascular morbidity and mortality. Pulse wave velocity (PWV) and augmentation index (AIx), which are markers of arterial stiffness, were used to determine the severity of vascular damage noninvasively. This study aimed to investigate the effects of solute volume removal and hemodynamic changes on PWV and AIx of a single hemodialysis session. Thirty hemodialysis patients were enrolled in the study. Before initiation of hemodialysis, every 15 minutes during hemodialysis, and 30 minutes after the completion of the session, measurements of PWV and AIx@75 (normalized with heart rate 75 bpm) were obtained from each patient. Body composition was analyzed by bioimpedance spectroscopy device before and 30 minutes after completion of the hemodialysis session. During the hemodialysis, no significant change was observed in AIx@75. However, PWV decreased steadily during the session reaching statistically significant level at 135th minute (P = 0.026), with a maximal drop at 210th minute (P < 0.001). At 210th minute, decrease in PWV correlated positively with the decrease in central systolic blood pressure, central diastolic blood pressure, central pulse pressure, augmentation pressure, and AIx@75. Multiple regression analysis showed that decrease in PWV at 210th minute was associated with decrease in central systolic blood pressure and central pulse pressure. Ultrafiltration during hemodialysis had no significant effect on PWV and AIx@75. Delta urea correlated positively with delta PWV at 240th minute. A significant decrease in PWV was observed during hemodialysis and correlated with urea reduction; however, we were unable to document any effect of volume removal on arterial stiffness.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effects of single hemodialysis session on arterial stiffness in hemodialysis patients

Öğünç

Akdam

Alp

et al. 2015

Hemodialysis International

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“…When considering risk factors for mortality and dialysis inadequacy among PD patients, recent focus has shifted from small-molecule clearance to fluid overload [9]. Fluid overload is considered a contributor to mortality and technique failure among PD patients due to its association with complications such as hypertension [10], heart failure [11], increased cardiovascular event [12], arterial stiffness [13] and peritonitis [14], as well as inflammation [15], malnutrition [15,16] and loss of residual renal function [17,18]. However, it remains unclear whether overhydration is an independent predictor of PD clinical outcomes or whether it just reflects underlying comorbidities such as hypertension and cardiac dysfunction.…”

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confidence: 99%

The Effect of Overhydration on Mortality and Technique Failure Among Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis

et al. 2018

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Background: Overhydration is common among peritoneal dialysis (PD) patients and can affect PD-related outcomes. This paper aims to systematically investigate whether bioimpedance-assessed overhydration is a predictor for mortality and technique failure in PD patients. Methods: We conducted a systematic review and meta-analysis of cohort studies on overhydration and prognosis in PD patients, strictly complying with the Preferred Reporting Items for Systematical Reviews and Meta-analyses. Results: Eight articles met the selection criteria and 5 studies were included in the meta-analysis. Meta-analyses-revealed overhydration, defined as a high ratio of extracellular water/total body water (ECW/TBW), was significantly associated with higher risk for all-cause mortality and technique failure. Other higher dichotomized overhydration indicators and continuous hydration variables all indicated overhydration as a significant risk factor for all-cause mortality. Conclusion: Overhydration, defined by a higher ratio of ECW/TBW, might be an independent predictor for all-cause mortality and technique failure among PD patients. However, more studies are needed to confirm this conclusion. Video Journal Club ‘Cappuccino with Claudio Ronco’ at https://www.karger.com/Journal/ArticleNews/223997?sponsor=52

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“…Diminished phase angle has been characterized as a marker of overhydration and arterial stiffness in hemodialysis patients, thus predicting mortality [34,35]. Again, reduced phase angle has been described as a marker of obesity and metabolic syndrome in women [36].…”

Section: Discussionmentioning

confidence: 99%

Is Intake of Vitamin D and Calcium Important for Cardiovascular Health in Elderly Obese Patients?

et al. 2012

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There is compelling evidence that bariatric weight loss reduces cardiovascular complications; however, these still tend to be the most common cause of late death after surgical intervention. In a prospective cohort study, correlations of dietary nutrients with indexes of vascular health were sought, with emphasis on vitamin D and calcium. Clinically stable obese outpatient subjects (>60 years old, N = 44) were interviewed about dietary macro and micronutrients. Nutritional assessment targeted anthropometric and bioimpedance analysis (BIA), hematologic counts, lipid profile, glucose homeostasis, and inflammatory markers. Carotid intima-media thickness (IMT) and brachial flow-mediated dilation (FMD), along with related vascular measurements, were documented, and results were correlated by uni- and multivariate analysis, corrected for known risk factors. IMT, FMD, and also brachial basal flow were positively influenced by vitamin D (P < 0.001). Calcium appeared beneficial for brachial basal flow only (P = 0.010). No association with IMT occurred, and a negative result for FMD was elicited. Also, vitamins A and B12 were advantageous for FMD, whereas iron was deleterious for IMT. Intake of many micronutrients including calcium and vitamin D did not meet recommendations. Vitamin D displayed a beneficial profile regarding vascular health, and more attention to this nutrient should be given, especially concerning obese patients with cardiometabolic risk. Calcium exhibited less straightforward results but deserves focus as well, along with antioxidant vitamin A as well as the B-complex which were mostly deficient in this experience.

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Changes in arterial stiffness following dialysis in relation to overhydration and to endothelial function

Cited by 17 publications

References 50 publications

The effects of single hemodialysis session on arterial stiffness in hemodialysis patients

The effects of single hemodialysis session on arterial stiffness in hemodialysis patients

The Effect of Overhydration on Mortality and Technique Failure Among Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis

Is Intake of Vitamin D and Calcium Important for Cardiovascular Health in Elderly Obese Patients?

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