Arterial Wave Reflection Is Elevated in Evening Hemodialysis Patients

Takenaka, Tsuneo; Mimura, Taku; Kanno, Yoshihiko; Ohno, Yoichi; Suzuki, Hiromichi

doi:10.1080/10641960802064542

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…Age, diabetes, duration of CKD, calcium levels, mean arterial pressure, left ventricular mass and C-reactive protein are predominant clinical determinants of arterial stiffness and the total dose of calcium based phosphate binders. 35,[55][56][57] Hypothesized mechanisms of arterial stiffness in uremia include chronic fluid overload, micro-inflammation, activation of the renin-aldosteroneangiotensin system and increased lipid oxidation. 6 Reduced arterial compliance seems to have a pivotal role in the generation of high blood pressure contributing to increased left ventricular workload and hypertrophy and CV mortality.…”

Section: Resultsmentioning

confidence: 99%

Does Vascular Calcification Correlate with Pulse Wave Velocity in Hemodialysis Patients?

Iorio

Cucciniello

2009

Nephrology Research & Reviews

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Vascular calcifications have been previously shown to be an independent predictor of mortality in dialysis patients and a similar association has been shown for arterial stiffness. Nonetheless, the relationship between vascular calcifications and pulse wave velocity (PWV) have so far been little explored. The goal of this study is to verify the correlation among vascular calcifications and rigidity of arterial wall in patients at dialysis start. Accordingly, we investigated the association between aortic PWV and coronary calcification measured by computed tomography (TC-score) in 105 adult incident hemodialysis patients. PWV resulted increased in patients with the higher TC-score values; indeed, at univariate analysis PWV directly correlated with age (p=0.016), presence of diabetes (p lower than 0.0001), serum phosphorus (p=0.0066), C-reactive protein (CRP) (p=0.046), LDL-cholesterol (p=0.043), TC-score (p lower than 0.0001), and inversely correlated with systolic blood pressure (p=0.036). At multivariate analysis, age, diabetes, serum phosphorus, CRP, LDL-cholesterol and vascular calcifications were determinants of arterial stiffening. Using the table “two for two”, we showed 6 false negative patients (high TC-score and low PWV) and 12 false positive patients (low TC-score and high PWV). The sensibility was 76% and the specificity 85%; the accuracy was 83%, the predictor positive value was 61% and the predictor negative value was 92%. Overall, a strong association between TC-score and PWV was seen.

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Section: Resultsmentioning

confidence: 99%

Does Vascular Calcification Correlate with Pulse Wave Velocity in Hemodialysis Patients?

Iorio

Cucciniello

2009

Nephrology Research & Reviews

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“…Our data are compatible with Jerrard-Dunne, Mahmud, and Feely (19), and suggest that an elevated arterial stiffness may account for the absence of a decrease in blood pressure at night in the patients with chronic kidney disease. Of importance, arterial stiffness parameters were dynamic ones, and can be affected by muscular arterial tone (20,21). Vasoactive agents, including sympathetic nerve activity and the renin-angiotensin system, participate in the regulation of muscular artery tone.…”

Section: Discussionmentioning

confidence: 99%

Time for Reflection Predicts the Progression of Renal Dysfunction in Patients with Nondiabetic Chronic Kidney Disease

Takenaka

Mimura

Kikuta

et al. 2009

Clinical and Experimental Hypertension

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Our previous data indicated that both home blood pressure and arterial stiffness predicted the progression of renal dysfunction in the patients with chronic kidney diseases. In the present study, we examined both home blood pressure and the parameters of arterial stiffness as the indicator to the progression of chronic kidney diseases. Forty-two nondiabetic chronic kidney disease patients were enrolled and followed for 1 year. Anti-hypertensive therapy was adjusted to achieve office blood pressure below 130/80 mmHg. Home blood pressure was examined twice a day in the morning and evening. Pulse wave velocity (PWV) and augmentation index (AI) were measured as the index of arterial stiffness. The time for reflection (TR) was also determined. The relationship of annual changes in serum creatinine (Scr) with the above parameters was assessed. Multivariate regression analysis revealed that TR inversely correlated to annual increase in Scr (beta = -0.03, p < 0.05). Home blood pressure did not correlate to annual changes in Scr in the present study. The present data indicated that arterial stiffness is elevated despite good blood pressure control in chronic kidney disease, especially among the dippings. In addition, our data suggest that PWV and AI correlated to each other, while they were influenced differently by hemodynamic factors. Finally, the present findings provide the evidence that the arterial stiffness parameter is more sensitive than home blood pressure as an indicator to the progression of chronic kidney disease.

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The Influence of a Direct Renin Inhibitor on the Central Blood Pressure

Kubota¹,

Asai²,

Yasutake³

et al. 2013

J Nippon Med Sch

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Arterial Wave Reflection Is Elevated in Evening Hemodialysis Patients

Abstract: Although a larger scale study is required to draw a definite conclusion, our findings suggest that a better prognosis in daytime hemodialysis non-diabetic patients is related to the lower AI.

Cited by 5 publications

References 28 publications

Does Vascular Calcification Correlate with Pulse Wave Velocity in Hemodialysis Patients?

Does Vascular Calcification Correlate with Pulse Wave Velocity in Hemodialysis Patients?

Time for Reflection Predicts the Progression of Renal Dysfunction in Patients with Nondiabetic Chronic Kidney Disease

The Influence of a Direct Renin Inhibitor on the Central Blood Pressure

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