Impact of anemia on aortic pulse wave velocity in hemodialysis patients

Recent studies indicate an increased mortality of anemic patients with renal failure when near-normal hemoglobin levels are aimed for by treatment with erythropoiesis stimulating agents. Aortic pulse wave velocity (aPWV) is a strong predictor of all-cause and cardiovascular mortality in patients with end-stage renal disease. The relationships between aPWV, hemoglobin levels and erythropoiesis stimulating agent dosage have not been evaluated to date.

In 75 patients, aPWV was measured by applanation tonometry. Associations of aPWV and a broad range of clinical, laboratory and therapeutic parameters were determined by stepwise linear regression analysis.

aPWV was positively correlated to age (r = 0.55, p < 0.001), whereas the association with hemoglobin was significant, but negative (r = -0.31, p = 0.01). Multivariate analysis determined age (beta = 0.513, p < 0.001), mean blood pressure (beta = 0.255, p = 0.01), the presence of heart failure (beta = 0.188, p = 0.03), hemoglobin (beta = -0.226, p = 0.01), daily calcium load (beta = -0.230, p = 0.01) and the presence of diabetes mellitus (beta = 0.179, p = 0.04) to have a significant and independent influence on aPWV.

This study demonstrates that in hemodialysis patients, aPWV is significantly but negatively associated with the serum hemoglobin concentration, even after multiple adjustments for other covariates.