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Effects of hemodialysis on blood volume, macro- and microvascular function.
- Source :
-
Microvascular research [Microvasc Res] 2020 May; Vol. 129, pp. 103958. Date of Electronic Publication: 2019 Nov 14. - Publication Year :
- 2020
-
Abstract
- Background: Vascular dysfunction is considered to spur the progression of cardiovascular disease in hemodialysis (HD) patients. Whether the HD procedure itself contributes to vascular dysfunction remains incompletely investigated. The present study sought to comprehensively assess the effects of HD on arterial and venous function along with concomitant changes in blood volume (BV).<br />Methods and Results: We determined BV with high-precision, automated carbon monoxide-rebreathing, arterial stiffness using applanation tonometry and intrinsic microvascular function via retinal vessel analysis prior to and after conventional 4-hour HD in fasting-controlled conditions in 10 patients. All HD patients were non-smokers and non-obese (body mass index = 22.8 ± 2.8 m·kg <superscript>-2</superscript> ). Hypertension (70%), coronary artery disease (40%) and diabetes mellitus (20%) were the most prevalent comorbidities. Prior to HD, all patients presented with hypervolemia (+2208 ± 1213 ml). HD decreased body weight (-1.72 ± 1.25 kg, P = 0.002) and plasma volume (-689 ± 566 ml, P = 0.004), while hematocrit (Hct) was concomitantly increased (+4.8 ± 4.5%, P = 0.009). HD did not affect large elastic artery stiffness, as determined by carotid-femoral pulse wave velocity (P = 0.448) and carotid distensibility (P = 0.562). In contrast, flicker light-induced retinal venular dilation was reduced by three-fourths after HD (-2.4 ± 1.7%, P = 0.039), in parallel to increased retinal venular diameter (+11.2 ± 4.9 μm, P = 0.002). In regression analyses, a negative association was observed between HD-induced changes in Hct and retinal venular dilation (r ≥ -0.89, P ≤ 0.045).<br />Conclusion: Conventional HD resulting in substantial plasma volume removal do not alter large artery elastic properties, whereas intrinsic microvascular venular dilator function is markedly impaired, an effect directly associated with the increase in hemoconcentration.<br />Competing Interests: Declaration of competing interest The authors state no conflict of interest.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Arteries diagnostic imaging
Cardiovascular Diseases diagnosis
Cardiovascular Diseases physiopathology
Carotid-Femoral Pulse Wave Velocity
Female
Hemodynamic Monitoring
Humans
Kidney Failure, Chronic complications
Kidney Failure, Chronic diagnosis
Kidney Failure, Chronic physiopathology
Male
Middle Aged
Photography
Treatment Outcome
Ultrasonography
Arteries physiopathology
Blood Volume
Cardiovascular Diseases etiology
Kidney Failure, Chronic therapy
Microcirculation
Renal Dialysis adverse effects
Retinal Vessels physiopathology
Vascular Stiffness
Venules physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1095-9319
- Volume :
- 129
- Database :
- MEDLINE
- Journal :
- Microvascular research
- Publication Type :
- Academic Journal
- Accession number :
- 31734376
- Full Text :
- https://doi.org/10.1016/j.mvr.2019.103958