Key result
Chronic hemodialysis patients exhibited significantly accelerated progression of aortic stiffness compared to the general population, with an average pulse wave velocity increase of 63.95 cm/sec versus 27.28 cm/sec over 36 months.
Cohort (n=140)
Yes
Absolute Event Rate: 63.95% vs 27.28%
p-value: p=<0.001
Chronic hemodialysis patients experience significantly accelerated progression of arterial stiffness compared to the general population, driven by both traditional risk factors and uremia-related factors.
May warrant enhanced vascular surveillance in hemodialysis; leaves open whether stiffness-targeted interventions improve outcomes.
BACKGROUND/AIMS: The aim of this study was to compare the progression of aortic stiffness in chronic hemodialysis patients (CHP) with that of general population patients (GPP) over a 36-month period and to evaluate the determinants of this progression. METHODS: The study group included 80 patients undergoing hemodialysis (aged 59.3 ± 11.8 years; duration of dialysis 5.47 ± 5.16 years). The control group consisted of 60 patients (aged 57.5 ± 10.9 years) with a glomerular filtration rate of > 60 mL/min/1.73 m(2). Pulse wave velocity (PWV) was determined from time diversity propagation of the common carotid artery and femoral artery by Doppler ultrasound. Clinical and biochemical parameters were determined in serum using standard laboratory procedures. RESULTS: The mean PWV values at baseline and 36 months were 11.18 ± 2.29 and 11.82 ± 2.34 m/sec in the CHP group, and 9.02 ± 1.89 and 9.29 ± 1.93 m/sec in the GPP group, respectively. The average PWV progressions were 63.95 ± 18.373 cm/sec in CHP and 27.28 ± 28.519 cm/sec in GPP. By multiple regression analysis, hemoglobin (standardized coefficient β [βst] = -0.405, p = 0.004; βst = -0.364, p = 0.011), albumin (βst = -0.349, p = 0.042; βst = -0.303, p = 0.034), CRP (βst = 0.458, p = 0.002; βst = 0.187, p = 0.008), and total cholesterol (βst = 0.236, p = 0.038; βst = 0.171, p = 0.078) were independently associated with PWV in the CHP and GPP groups, respectively. CONCLUSIONS: Accelerated arterial stiffness was more pronounced in the CHP group than in the GPP group. The independent determinants of this progression in both groups include traditional risk factors and blood levels of hemoglobin, albumin and CRP. Cholesterol and uremia-related factors are determinants only in CHP.
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Avramovski et al. (2013) conducted a cohort in End-stage renal disease on hemodialysis (n=140). Chronic hemodialysis vs. General population (GFR > 60 mL/min/1.73 m2) was evaluated on Progression of pulse wave velocity (ΔPWV) over 36 months (p=<0.001). Chronic hemodialysis patients exhibited significantly accelerated progression of aortic stiffness compared to the general population, with an average pulse wave velocity increase of 63.95 cm/sec versus 27.28 cm/sec over 36 months.
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