Related Experiment Video
Updated: Aug 15, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Increased arterial stiffness in children on haemodialysis
Adrian Covic1, Nicoleta Mardare, Paul Gusbeth-Tatomir
1Dialysis and Transplantation Center, C. I. Parhon University Hospital, Iaşi, Romania. acovic@xnet.ro
Insights
Children on haemodialysis (HD) show significantly increased aortic stiffness, similar to adults. This arterial stiffness, measured by pulse wave velocity (PWV) and augmentation index (AIx), appears to be a structural change unrelated to dialysis treatment.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Physiology
- Vascular Biology
Background:
- Aortic stiffness, measured by pulse wave velocity (PWV) and augmentation index (AIx), predicts survival in adult haemodialysis (HD) patients.
- Limited data exist on arterial stiffness in pediatric renal populations.
Purpose of the Study:
- To investigate arterial stiffness in children undergoing haemodialysis.
- To compare aortic stiffness parameters between children on HD and healthy controls.
Main Methods:
- Applanation tonometry and SphygmoCor device used to measure PWV and AIx.
- Study included 14 children on HD and 15 age/height-matched controls.
- Arterial waveforms analyzed for stiffness parameters.
Main Results:
- Children on HD exhibited significantly higher AIx and PWV compared to controls (P < 0.0001).
- Blood pressure was the only significant difference between groups.
- Dialysis treatment did not impact AIx or PWV levels post-treatment.
Conclusions:
- End-stage renal disease is associated with increased arterial stiffness in children, comparable to adult levels.
- The findings suggest structural rather than functional alterations underlie increased stiffness.
- Dialysis does not appear to ameliorate this arterial stiffness.
Background:
Measures of aortic stiffness--aortic pulse wave velocity (PWV) and augmentation index (AIx)--have been shown to be powerful predictors of survival in adult haemodialysis (HD) patients. Very few data have been reported regarding arterial stiffness in paediatric renal populations.
Methods:
PWV and aortic AIx were determined from contour analysis of arterial waveforms recorded by applanation tonometry using a SphygmoCor device in 14 children on HD (age = 14.1 years) and in 15 age, height matched children controls.
Results:
Pre-HD AIx (29.7 +/- 15.4%) and PWV (6.6 +/- 1.0 m/s) were significantly higher compared with children controls (8.3 +/- 8.0% and 5.4 +/- 0.6 m/s, respectively, P < 0.0001). The only significant difference between normal and HD children was BP level: 103/61 vs 114/72 mmHg, P < 0.05. In children of HD patients, a multiple linear regression model including BP, age, height, weight, Ca and P levels as independent variables accounted for 57% of the variability in AIx. Dialysis had no impact on AIx (post-HD: 28.5 +/- 12.7%) or on PWV (post-HD: 6.7 +/- 0.8 m/s).
Conclusions:
We show, in this first-ever report of increased arterial stiffness in children on dialysis, that end-stage renal disease is associated with abnormalities in arterial wall elastic properties, comparable with adult levels, even in childhood. Most importantly, the absence of a discernible amelioration with dialysis implies that purely structural and not functional alterations lie behind the increased arterial stiffness.
Related Concept Videos
01:24Hemodialysis II: Procedure and Complications
01:24Chronic Kidney Disease II: Clinical Manifestations
01:25Hemodialysis I: Introduction
01:25Hemodialysis III: Nursing Management
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:18Hypertension and Regulation of Blood Pressure