P-303: The effect of ultrafiltration volume during hemodialysis on the elastic properties of the aorta in patients on chronic renal failure

Aortic distensibility (AoD), an important parameter of left ventricular function is reduced in patients (pts) with end-stage chronic renal failure (CRF) and is known to improve by hemodialysis (HD). The aim of the present study was to evaluate the effect of dialysis ultrafiltration volume on the ela...

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Bibliographic Details
Published in:American journal of hypertension 2003-05, Vol.16 (S1), p.146A-146A
Main Authors: Soubassi, Lygeri P., Chaniotis, Dimitrios I., Soubassi, Sofia P., Lekakis, Ioannis K., Pitsavos, Christos H., Stefanadis, Christodoulos C., Toutouzas, Pavlos K., Mavrikakis, Myron E.
Format: Article
Language:English
Subjects:
elastic properties
hemodialysis
ultrafiltration volume
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Summary:Aortic distensibility (AoD), an important parameter of left ventricular function is reduced in patients (pts) with end-stage chronic renal failure (CRF) and is known to improve by hemodialysis (HD). The aim of the present study was to evaluate the effect of dialysis ultrafiltration volume on the elastic properties (EP) of the aorta in pts with CRF and different retention volumes. Twenty nine pts (16 men and 13 women, aged 44±15 years), on regular chronic HD for more than one year, were studied. The AoD was measured before and at the end of the same HD session. All pts were on bicarbonate HD, received erythropoietin and did not smoke. Patients were divided into two groups: group I; pts who came on HD with < 2Kg over their dry weight, group II; pts who came on HD with ≥ 2 Kg over their dry weight. No differences were observed between the two groups regarding: age, sex, hematocrit, serum creatinine, cholesterol, triglycerides, HDL-C, LDL-C, Apo A, Apo B, Lp (a), systolic and diastolic blood pressure in the pre and post HD measurements. The AoD was calculated by the formula: AoD=2x (S-D)/(DxPP) where S is the systolic and diameters the diastolic aortic diameter and PP the pulse pressure. The aortic were evaluated with the m-mode in the parasternal long axis view. Pressures were obtained by sphygmomanometry at the branchial artery. The difference of AoD (cm2x dyn−1 x 10−6) in group I was 1.15± 0.47 and in group II = 0.54± 0.51. The comparison between the changes of AoD in the two groups showed a statistically significant difference (student's t-test, p=0.0003). The above results were confirmed by the Mann-Whitney test (p=0.002). From our results it is concluded that the effect of HD on the EP of the aorta is more favourable in pts who retain less than two kilos of fluid between two HD sessions. The mechanisms as well as the short and long term hemodynamic consequences of this effect need further evaluation.
ISSN:0895-7061
1879-1905
1941-7225
DOI:10.1016/S0895-7061(03)00468-0