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Does Pulse Wave Velocity Increase Over Time in Hemodialysis Patients?
Theerasak Tangwonglert1, Andrew Davenport2
1Nephrology Division, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand.
Blood Purification
|December 22, 2020
Summary
Arterial stiffness (PWV) did not change overall in hemodialysis patients after five years. Changes in PWV were linked to blood pressure, not fluid overload (ECW).
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Biomedical Engineering
Background:
- Arterial stiffness, measured by pulse wave velocity (PWV), is elevated in hemodialysis (HD) patients, contributing to cardiovascular mortality.
- Previous research suggests a link between extracellular water (ECW) and PWV.
Purpose of the Study:
- To investigate if arterial stiffness (PWV) increases over time in hemodialysis patients.
- To determine if changes in PWV are associated with extracellular water (ECW) levels.
Main Methods:
- A review of repeat aortic pulse wave velocity (PWV) measurements using an oscillograph method.
- Extracellular water (ECW) was measured using multifrequency bioimpedance in hemodialysis patients.
- Measurements were taken at least 5 years apart in 24 hemodialysis patients.
Main Results:
- No significant overall change in PWV or ECW was observed after approximately 5 years of hemodialysis.
- The ratio of ECW to total body water increased significantly (p < 0.05).
- Changes in PWV were not associated with changes in ECW (r = -0.05, p = 0.84) but were associated with changes in peri-dialytic systolic blood pressure (SBP) (r = 0.59, p = 0.007).
Conclusions:
- In this observational study, arterial stiffness (PWV) did not uniformly increase over 5 years in hemodialysis patients; 50% increased and 50% decreased.
- Changes in PWV were not correlated with extracellular water (ECW) but were associated with systolic blood pressure fluctuations.
- Further interventional studies are needed to explore if blood pressure management can reduce PWV in hemodialysis patients.
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