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Updated: May 31, 2026
08:50
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Intradialytic hypertension and its association with endothelial cell dysfunction
Jula K Inrig1, Peter Van Buren, Catherine Kim
1UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8523, USA. jula.inrig@utsouthwestern.edu
Summary
Intradialytic hypertension, a condition in hemodialysis patients, is linked to endothelial cell dysfunction. This dysfunction may contribute to the increased adverse cardiovascular outcomes observed in these individuals.
Area of Science:
- Nephrology
- Cardiovascular Science
- Endothelial Biology
Background:
- Intradialytic hypertension (IDH) is linked to poor patient outcomes, but its underlying mechanisms are unclear.
- Existing evidence suggests imbalances in vasoregulators, pointing towards endothelial dysfunction.
- This study investigates IDH's direct association with endothelial cell dysfunction in vivo.
Purpose of the Study:
- To determine if intradialytic hypertension is associated with endothelial cell dysfunction in hemodialysis patients.
- To explore endothelial cell dysfunction as a potential predictor of adverse cardiovascular outcomes in this population.
Main Methods:
- A case-control study compared 25 hemodialysis patients with IDH to 25 without.
- Endothelial progenitor cells (EPCs) were assessed using aldehyde dehydrogenase activity (ALDHbr) and cell surface markers (CD34+CD133+).
- Endothelial function was evaluated via brachial artery flow-mediated dilation (FMD) normalized for shear stress.
Main Results:
- Patients with IDH showed significantly higher postdialysis systolic blood pressure compared to controls.
- Impaired endothelial cell function was observed in the IDH group, indicated by lower ALDHbr and CD34+CD133+ cell counts.
- Flow-mediated dilation (FMD) was significantly reduced in patients with intradialytic hypertension.
Conclusions:
- Intradialytic hypertension is demonstrably associated with endothelial cell dysfunction.
- Endothelial cell dysfunction may be a key factor contributing to the elevated event rates seen in patients with IDH.
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