Acute effects of haemodialysis on endothelial function and large artery elasticity

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2001-08, Vol.16 (8), p.1663-1668
• Main Authors: Kosch, Markus, Levers, Andrea, Barenbrock, Michael, Matzkies, Fritz, Schaefer, Roland M., Kisters, Klaus, Rahn, Karl‐Heinz, Hausberg, Martin
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; arterial distensibility; Arteries - physiopathology; Biological and medical sciences; Brachial Artery - physiopathology; Carotid Arteries - physiopathology; Elasticity; Emergency and intensive care: renal failure. Dialysis management; endothelial dysfunction; Endothelium, Vascular - physiopathology; Female; flow‐mediated vasodilation; haemodialysis; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; pulse wave velocity; Regional Blood Flow; Renal Dialysis; Time Factors; Vasodilation
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/16.8.1663

Background. Disturbances of functional properties of large arteries contribute to increased cardiovascular morbidity and mortality in patients with end‐stage renal disease. However, it is not clear whether haemodialysis per se acutely affects mechanical vessel wall properties or endothelial function. Methods. Twenty‐five chronic haemodialysis patients (mean±standard error of the mean (SEM): age 52±5 years; time on dialysis 63±7 months; blood pressure 132±4/72±2 mmHg) were studied before and immediately after a haemodialysis (HD) session using a polysulphone dialyser (ultrafiltration 1460±54 ml), as well as on the following day. Blood pressure was measured with an automatic sphygmomanometer and applanation tonometry. End‐diastolic diameter and distension of the brachial and carotid arteries were measured by Doppler frequency analysis of vessel wall movements in M‐mode using a multigate pulsed Doppler system and aortic pulse wave velocity (PWV) by an automatic device (Complior®). Endothelial function was determined as brachial artery flow‐mediated dilation (FMD) and compared with endothelium‐independent nitroglycerine‐induced dilation (NMD). Results. FMD was 7.9±1.8% in patients before HD and did not change significantly after HD or in the dialysis‐free intervall (6.7±2.1 and 7.1±2.0%, respectively; NS). The same was true for NMD and PWV (12.6±0.8 m/s before HD, 12.8±0.8 m/s after HD, and 11.9±0.7 m/s on the HD‐free day). Carotid distensibility coefficients decreased significantly during HD (from 18.1±1.9×10−3/kPa to 16.7±2.2×10−3/kPa, P