Correlation between Pulse Wave Velocity and Fluid Distribution in Hemodialysis Patients

Zheng, Deyi; Cheng, Lei; Zhuang, Zhen W.; Gu, Yan; Tang, Lijun; Wang, Tao

doi:10.1159/000199432

Cited by 24 publications

(37 citation statements)

References 31 publications

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“…It has been shown that excess fluid plays an important role in the development of arterial stiffness in dialysis patients by increasing arterial distension and systolic blood pressure. 47,48 A positive strong correlation has been determined between PWV and excess fluid in our study, suggesting that excess fluid leads to an increase of arterial stiffness and cardiovascular diseases.…”

Section: Discussionsupporting

confidence: 71%

Assessment of volume status and arterial stiffness in chronic kidney disease

et al. 2013

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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.

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Section: Discussionsupporting

confidence: 71%

Assessment of volume status and arterial stiffness in chronic kidney disease

et al. 2013

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“…This finding may be associated with cardiovascular instability and probably increased ECV and BP observed mainly in patients on HD than those on HDF, but because of the good status of the enrolled patients, we did not observe significant differences. A previous study has reported that volume overload plays an important role in the development of arterial stiffness in HD patients [28]. Additionally, it has been reported that PWV varies during dialysis due to alterations in hydration status [29].…”

Section: Discussionmentioning

confidence: 99%

β<sub>2</sub>-Microglobulin, Pulse Pressure and Metabolic Alterations in Hemodialysis Patients

Raikou

Tentolouris²,

Kyriaki³

et al. 2010

Nephron Clin Pract

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Background/Aim: Pulse pressure (PP) is a result of arterial stiffness seen in dialysis patients, but may be a consequence of fluid overload. We examined the role of β₂-microglobulin (β₂M) in PP in relation to metabolic alterations in patients on different hemodialysis (HD) modalities. Methods: We studied 76 hemodialyzed patients on regular HD (n = 34), predilution bagged hemodiafiltration (n = 19) and online predilution hemodiafiltration (n = 23). β₂M levels were measured by radioimmunoassay, and the clearance of β₂M was assessed by Kt/V for β₂M. Arterial stiffness was measured as carotid-femoral pulse wave velocity, and PP was derived. Insulin levels were measured using immunoradioassay, and insulin resistance was calculated using homeostasis model assessment insulin resistance (HOMA-IR). Serum bicarbonate levels were measured using a blood gas analyzer, and percent sodium removal was calculated. Results: β₂M levels predict increased PP (p = 0.02) adjusting for age, HD modalities, HD duration, HOMA-IR and percent sodium removal. β₂M was positively associated with HOMA-IR (r = 0.306, p = 0.007). Serum bicarbonate levels and carotid-femoral pulse wave velocity were inversely associated (r = –0.719, p = 0.001). Conclusions: β₂M levels were positively associated with PP, which was influenced mainly by dialysis modality fluid and sodium balance and less by arterial stiffness. β₂M levels were positively associated with insulin resistance. Uremic acidosis may contribute to arterial stiffness.

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“…This was proven by the loss in body weight in the study group. A lower volume overload should therefore decrease the degree of arterial stiffness [21], which in turn should cause the oscillometric BP measurements to be more accurate.…”

Section: Discussionmentioning

confidence: 99%