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Nitroglycerin mediated dilation evaluated by ultrasound is associated with sTWEAK in hemodialysis patients

Crina Claudia Rusu1, Liviu Ghervan2, Simona Racasan3

  • 1Department of Nephrology and Dialysis, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. crinaclaudiarusu@yahoo.ro.

Medical Ultrasonography
|March 11, 2016
PubMed

Insights

In hemodialysis patients, sTWEAK levels predict nitroglycerin-mediated dilation, while dialysis efficiency (Kt/V) predicts flow-mediated dilation. These findings highlight distinct vascular function determinants in this population.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Vascular Ultrasound

Background:

  • Cardiovascular disease is the leading cause of mortality in hemodialysis (HD) patients.
  • Brachial artery ultrasound can non-invasively assess atherosclerosis, but determinants of arterial function may differ in HD patients.
  • Tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) is an emerging atherosclerotic marker in chronic kidney disease (CKD).

Purpose of the Study:

  • To evaluate the determinants of brachial artery function, specifically flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD), in HD patients.
  • To investigate the relationship between arterial function and sTWEAK levels, a marker of atherosclerosis in CKD.

Main Methods:

  • A cross-sectional observational study involving 54 hemodialysis patients.
  • Clinical and biological data were collected, and serum sTWEAK levels were measured using ELISA.
  • Brachial artery FMD and NMD were assessed using B-mode ultrasound.

Main Results:

  • FMD determinants included Kt/V (r=0.47, p<0.001), LDL-cholesterol (r=0.29, p=0.04), and total cholesterol (r=0.31, p=0.02). Kt/V was the sole significant predictor in multivariate analysis (p=0.04).
  • NMD correlated with sTWEAK (r=-0.30, p=0.03), systolic blood pressure (r=-0.28, p=0.04), and pulse pressure (r=-0.31, p=0.02).
  • sTWEAK was the only significant predictor for NMD in multivariate analysis (p=0.04).

Conclusions:

  • sTWEAK is the primary determinant of nitroglycerin-mediated dilation in HD patients, with decreased NMD linked to higher blood pressure and pulse pressure.
  • Kt/V is the main determinant of flow-mediated dilation, indicating that better dialysis efficiency is associated with improved FMD.
  • Increased FMD correlates with enhanced dialysis efficiency and favorable lipid profiles (high total cholesterol and LDL-cholesterol).
Abstract

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