Effects of thrice weekly nocturnal hemodialysis on arterial stiffness.

Abstract:

OBJECTIVE:In this study, we compared the changes in arterial stiffness in chronic hemodialysis patients treated with 8-h vs. 4-h thrice weekly in-center hemodialysis. METHODS:Sixty prevalent chronic hemodialysis patients assigned to 8-h nocturnal in-center thrice weekly HD (NHD) and 60 control cases assigned to 4-h thrice weekly conventional HD (CHD) were followed for one year. Radial-carotid pulse wave velocity, augmentation index and echocardiography were performed at baseline and 12th month. RESULTS:Mean age of the patients was 49±11 years, 30.8% were female, 27.5% had diabetes mellitus and mean dialysis vintage was 57±47 months. Baseline demographical, clinical and laboratory parameters were similar between groups. During a mean follow-up of 15.0±0.1 months, blood pressure remained similar in both groups while the number of mean daily anti-hypertensive substances decreased in the NHD group. In the NHD group, time-averaged serum phosphorus and calcium-phosphorus product were lower than the CHD group. Pulse wave velocity and augmentation index decreased in the NHD group (from 11.02±2.51 m/s to 9.61±2.39 m/s and from 28.8±10.3% to 26.2±12.1%; p=0.008 and p=0.04, respectively). While augmentation index increased in the CHD group (28.0±9.4 to 31.0±10.7%, p=0.02), pulse wave velocity did not change. Subendocardial viability ratio and ejection duration improved in the NHD group (from 135±28 to 143±25%, p=0.01 and from 294±34 ms to 281±34 ms, p=0.003, respectively), accompanied by regression of left ventricular mass index. In multiple stepwise linear regression analyses, NHD was associated with improvements in augmentation index, ejection duration and subendocardial viability ratio. CONCLUSIONS:These data indicate that arterial stiffness is ameliorated by implementation of longer hemodialysis sessions.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Demirci MS,Celik G,Ozkahya M,Tumuklu M,Toz H,Asci G,Duman S,Basci A,Kircelli F,Ozdogan O,Demirci C,Can L,Isik IO,Ok E,Long Dialysis Group.

doi

10.1016/j.atherosclerosis.2011.11.015

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

477-85

issue

2

eissn

0021-9150

issn

1879-1484

pii

S0021-9150(11)01084-7

journal_volume

220

pub_type

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