Reproducibility of systemic hemodynamics in stable chronic hemodialysis: a pilot study

Vij, Rajiv; Motiwala, Shaheen; Peixoto, Aldo J.

doi:10.1097/mbp.0b013e3283057ae4

Cited by 1 publication

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“…However, this feature of our study design has limited potential for confounding, because, in every patient, HD prescription was identical between the two successive HD sessions. In stable ESRD patients (as were those of the present study), haemodynamic conditions either before or after HD are reproducible between HD sessions [66].…”

Section: Study Limitationsmentioning

confidence: 84%

Haemodialysis acutely reduces the plasma levels of ADMA without reversing impaired NO-dependent vasodilation

et al. 2009

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End-stage renal disease patients have endothelial dysfunction and high plasma levels of ADMA (asymmetric omega-NG,NG-dimethylarginine), an endogenous inhibitor of NOS (NO synthase). The actual link between these abnormalities is controversial. Therefore, in the present study, we investigated whether HD (haemodialysis) has an acute impact on NO-dependent vasodilation and plasma ADMA in these patients. A total of 24 patients undergoing maintenance HD (HD group) and 24 age- and gender-matched healthy controls (Control group) were enrolled. The increase in forearm SkBF (skin blood flow) caused by local heating to 41 degrees C (SkBF41), known to depend on endothelial NO production, was determined with laser Doppler imaging. SkBF41 was expressed as a percentage of the vasodilatory reserve obtained from the maximal SkBF induced by local heating to 43 degrees C (independent of NO). In HD patients, SkBF41 was assessed on two successive HD sessions, once immediately before and once immediately after HD. Plasma ADMA was assayed simultaneously with MS/MS (tandem MS). In the Control group, SkBF41 was determined twice, on two different days, and plasma ADMA was assayed once. In HD patients, SkBF41 was identical before (82.2+/-13.1%) and after (82.7+/-12.4%) HD, but was lower than in controls (day 1, 89.6+/-6.1; day 2, 89.2+/-6.9%; P<0.01 compared with the HD group). In contrast, plasma ADMA was higher before (0.98+/-0.17 micromol/l) than after (0.58+/-0.10 micromol/l; P<0.01) HD. ADMA levels after HD did not differ from those obtained in controls (0.56+/-0.11 micromol/l). These findings show that HD patients have impaired NO-dependent vasodilation in forearm skin, an abnormality not acutely reversed by HD and not explained by ADMA accumulation.

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Section: Study Limitationsmentioning

confidence: 84%

Haemodialysis acutely reduces the plasma levels of ADMA without reversing impaired NO-dependent vasodilation

et al. 2009

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Reproducibility of systemic hemodynamics in stable chronic hemodialysis: a pilot study

Abstract: In this pilot study, hemodynamic variables have acceptable reproducibility in chronic stable HD patients. Our results are relevant to the use of hemodynamic monitoring in HD practice and research.

Cited by 1 publication

References 12 publications

Haemodialysis acutely reduces the plasma levels of ADMA without reversing impaired NO-dependent vasodilation

Haemodialysis acutely reduces the plasma levels of ADMA without reversing impaired NO-dependent vasodilation

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