Two years of maintenance hemodialysis has a pronounced effect on arterial stiffness progression
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The change of aortic stiffness, but not the particular baseline value, plays a crucial role in estimating the patient risk with end-stage renal disease. Therefore, we aimed to analyze the evolution of central and peripheral arterial stiffness in hemodialysis population without previous cardiovascular events during a 2-year follow-up.
60 hemodialysis patients (mean age 57.61 ± 13.01 years) were prospectively interviewed, and they underwent blood tests, chest X-ray for aortic calcification evaluation and pulse wave velocity (PWV) measurements at the baseline, after 6 months and after 2 years of observation period.
We found significant progression of aortic PWV (12.73 vs. 14.24 m/s, p = 0.032) and regression of brachial PWV (11.53 vs. 8.85 m/s, p < 0.001). CRP increase influenced evolution of aortic PWV (β = 0.331, p = 0.031, R2 = 0.599). Higher β2-microglobulin values was related to the progression of aortic PWV (β = 0.219, p = 0.022, R2 = 0.568). Mean arterial blood pressure had influence only on the short-term arterial stiffness evolution.
Patients on maintenance hemodialysis experience pronounced changes of arterial stiffness during the 2-year follow-up period. The progression of aortic stiffness is related to inflammatory response and particularly is influenced by β2-microglobulin concentration and aortic calcification.
KeywordsArterial stiffness Dialysis Progression Pulse wave velocity Vascular remodeling
The authors are grateful to Modesta Petraviciute and Migle Gudynaite for data collection, to Dialysis Department personnel for blood sample collection, to Dr. Ligita Ryliskyte and Kristina Galiauskiene for scientific and technical advises in measuring pulse wave velocity. On behalf of all authors, special thanks to Tetsuya Ogawa from Division of Blood Purification and Nephrology, Department of Medicine, Tokyo Women’s Medical University Medical Center, for providing a sample of aortic arch calcification score and sharing the methodology.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
This study was conducted with all the subjects’ written informed consent and in accordance with the 1964 Helsinki declaration and its later amendments. It was also approved by the Vilnius Regional Biomedical Research Ethics Committee (Permission Nr.1582000-14-750-268).
Patients were informed, and they consented to conduct the study.
- 5.NKF KDOQI Guidelines [Internet]. http://www2.kidney.org/professionals/kdoqi/guidelines_nutrition/nut_a05.html. Cited 21 Aug 2017
- 6.Briet M, Burns KD (2012) Chronic kidney disease and vascular remodelling: molecular mechanisms and clinical implications. Clin Sci Lond Engl 1979 123:399–416Google Scholar
- 9.Scuteri A, Chen CH, Yin FC et al (2001) Functional correlates of central arterial geometric phenotypes. Hypertens Dallas Tex 1979. 38:1471–1475Google Scholar
- 12.Early Vascular Aging (EVA) 1st Edition [Internet]. https://www.elsevier.com/books/early-vascular-aging-eva/nilsson/978-0-12-801387-8. Cited 7 Jul 2017
- 17.Laucyte-Cibulskiene A, Petraviciute M, Gudynaite M, Gumbys L, Valanciene D, Galiauskiene K, Ryliskyte L, Rimsevicius L, Miglinas M, Strupas K (2018) Mismatch between stiffness in elastic and muscular arteries as a predictor of vascular calcification in dialysis patients. Aging Clin Exp Res 30:375–382CrossRefGoogle Scholar
- 19.National Kidney Foundation (2003) K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis Off J Natl Kidney Found. 42:S1-S201Google Scholar
- 21.LeBoeuf A, Mac-Way F, Utescu MS et al (2011) Impact of dialysate calcium concentration on the progression of aortic stiffness in patients on haemodialysis. Nephrol Dial Transpl Off Publ Eur Dial Transpl Assoc Eur Ren Assoc. 26:3695–3701Google Scholar
- 22.Scuteri A, Morrell CH, Orrù M et al (2014) Longitudinal perspective on the conundrum of central arterial stiffness, blood pressure, and aging. Hypertens Dallas Tex 1979 64:1219–1227Google Scholar
- 27.Mac-Way F, Poulin A, Utescu MS et al (2014) The impact of warfarin on the rate of progression of aortic stiffness in hemodialysis patients: a longitudinal study. Nephrol Dial Transpl Off Publ Eur Dial Transpl Assoc Eur Ren Assoc. 29:2113–2120Google Scholar