Korean J Nephrol.  2008 Jan;27(1):102-109.

Association of Arterial Stiffness with the Decrease of Post-Dialysis Blood Pressure in Maintained Hemodialysis Patients

Affiliations
  • 1Division of Nephrology, Department of Internal Medicine The Catholic University of Korea, Seoul, Korea. kbsnep@catholic.ac.kr

Abstract

PURPOSE: Cardiovascular disease is one of the leading causes of mortality and morbidity in hemodialysis patients. Arterial stiffness is known to be associated with vascular calcification in HD patients. Post-dialysis hypotension is a risk factor for cardiovascular mortality. We evaluated the relation between arterial stiffness and post-dialysis blood pressure in maintained HD patients.
METHODS
72 HD patients were enrolled in this study. They had been under maintenance HD for more than 3 months. We checked the biochemical data, including the troponin T, CRP and OPG (osteoprotegerin) levels before their dialysis session and the baPWV (brachio-ankle pulse wave velocity) after the session. We defined post-dialysis BP decrease as a drop of BP of more than 5% of the average MAP for 2 weeks (6 sessions).
RESULTS
There were 34 and 38 patients with and without post-dialysis BP decrease, respectively. The BP decrease group had higher CRP, troponin T and OPG levels (p<0.05, 0.01 and 0.01, respectively). The PWV was higher in the BP decrease group (p<0.001). The CRP and troponin T levels were positively correlated with the PWV (r=0.26, p<0.05; r=0.31, p<0.01, respectively). The OPG level was positively correlated with the PWV (r=0.44, p<0.001). Age, pre-dialysis pulse pressure and drops in the patients MAP were correlated with the PWV (r=0.33, p<0.05; r=0.31, p<0.05; r=0.30, p<0.05, respectively). On multivariate analysis, PWV was the independent factor related to the drops in the MAP of the patients (beta=0.311, p=0.021).
CONCLUSION
Arterial stiffness is associated with post-dialysis blood pressure decrease.

Keyword

Dialysis; Hypotension; Atherosclerosis

MeSH Terms

Atherosclerosis
Blood Pressure
Cardiovascular Diseases
Dialysis
Humans
Hypotension
Multivariate Analysis
Renal Dialysis
Risk Factors
Troponin T
Vascular Calcification
Vascular Stiffness
Troponin T
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