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Dialysis improves endothelial function in humans.

J M Cross1, A Donald, P J Vallance

  • 1Centre for Clinical Pharmacology and Therapeutics, Department of Medicine, University College London, 5 University Street, London WC1E 6JJ, UK.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|August 28, 2001
PubMed
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Hemodialysis improved endothelial function by reducing harmful toxins in patients with chronic kidney disease. This effect was temporary, highlighting the impact of dialyzable toxins on vascular health.

Area of Science:

  • Nephrology
  • Vascular Biology
  • Cardiovascular Medicine

Background:

  • Circulating toxins in chronic renal failure impair endothelial function, contributing to vascular disease.
  • Dialysis aims to remove these toxins, but its effect on endothelial function requires further investigation.

Purpose of the Study:

  • To determine if reducing plasma concentrations of dialyzable toxins improves endothelial function.
  • To compare the acute effects of hemodialysis (HD) versus automated peritoneal dialysis (APD) on endothelial function.

Main Methods:

  • Assessed endothelial function using brachial artery flow-mediated dilatation (FMD) via ultrasound in 16 HD and 14 APD patients.
  • Measured plasma levels of endothelial inhibitors: asymmetric dimethyl-l-arginine and homocysteine.
  • Evaluated FMD before and after a single dialysis session, comparing it to glyceryl trinitrate-induced dilatation.

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Main Results:

  • Hemodialysis significantly increased FMD (4.0% to 5.8%, P<0.002), an effect lasting 5 hours.
  • Automated peritoneal dialysis showed no significant acute change in FMD (5.9% to 5.4%, P>0.5).
  • Neither HD nor APD affected glyceryl trinitrate-induced dilatation, indicating specific improvement in flow-mediated endothelial function.

Conclusions:

  • Short-term reduction of endothelial toxins via hemodialysis is linked to improved endothelial function.
  • These findings suggest that dialyzable toxins negatively impact endothelial function, with effects that are rapidly reversible.