Hemodialysis patients with intradialytic rise in blood pressure display higher baseline aortic stiffness and negligible drop in augmentation index with dialysis

International Urology and Nephrology
Panagiotis I GeorgianosPantelis A Sarafidis

Abstract

In hemodialysis patients, the intradialytic rise in blood pressure (BP) is associated with increased mortality risk. However, the mechanisms of this adverse effect are not yet elucidated. This study examined whether intradialytic rise in BP is associated with increased arterial stiffness and wave reflections, which are powerful cardiovascular risk predictors in hemodialysis. The pattern of intradialytic hemodynamic response was evaluated in 70 prevalent hemodialysis patients, by measuring seated brachial BP before and after the mid-week dialysis session. All patients had pre- and post-dialysis determination of aortic pulse wave velocity (PWV) and heart rate-adjusted augmentation index [AIx(75)], as measures of arterial stiffness and wave reflections, with the Sphygmocor device. Intradialytic rise in brachial systolic BP (SBP) was evident in 17 patients, whereas intradialytic change in SBP (ΔSBP) of -10 to 0 mmHg was observed in 23 and ΔSBP greater than -10 mmHg in 30 patients. Participants with intradialytic SBP rise had significantly higher pre-dialysis aortic PWV (10.4 ± 1.6 vs 8.3 ± 1.9 vs 9.4 ± 2.4 m/s, P < 0.01) and AIx(75) (28.1 ± 7.3 vs 21.7 ± 8.6 vs 25.8 ± 8.2%, P < 0.05) than those experiencing intradialytic ΔSBP of -1...Continue Reading

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Citations

Apr 12, 2017·Current Opinion in Nephrology and Hypertension·Peter Noel Van Buren
Jul 1, 2017·Seminars in Dialysis·Peter Noel Van Buren, Jula K Inrig
Oct 17, 2018·Clinical and Experimental Hypertension : CHE·Lu-Xi Zou, Ling Sun
Feb 27, 2020·Kidney & Blood Pressure Research·Christoffer Svinth-JohansenPer Ivarsen

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