Key result
Peripheral vascular disease in hemodialysis patients was associated with altered autonomic control, including higher very low frequency diastolic blood pressure variability and reduced cardiac baroreflex.
Why the study?
Does hemodialysis induce different blood pressure variability and autonomic control responses in patients with peripheral vascular disease compared to those without?
Observational
Does hemodialysis induce different blood pressure variability and autonomic control responses in patients with peripheral vascular disease compared to those without?
Hemodialysis induces significant increases in pulse pressure and alters autonomic control specifically in patients with peripheral vascular disease, potentially contributing to their higher mortality risk.
Suggests autonomic changes may mark higher-risk hemodialysis patients with PVD; leaves open causal mechanisms and targeted interventions.
Hemodialysis (HD) patients with peripheral vascular disease (PVD) are at higher risk of mortality. The main objectives of this work were to investigate the hypothesis of an association between the PVD and an altered control system on peripheral resistance in response to volume depletion induced by HD treatment; and to investigate whether HD induced increase of pulse pressure (PP) is associated with PVD. Continuous blood pressure (BP) was recorded during HD treatment at the beginning and at the end of HD. The overhydration condition was evaluated by means of whole body bioimpedance spectroscopy, measured before each HD treatment. BP variability, heart rate variability and baroreflex sensitivity were then analyzed. Patients affected by PVD reported a prevalence of peripheral local control as shown by higher values of very low frequency in diastolic blood pressure (DBP) variability and a reduced cardiac baroreflex with respect to patients not affected by this pathology. HD treatment induced a significant increase of PP and LF% in DBP series in PVD patients only. Our results suggested that differences in BP variability and PP changes could be related not only to an underlying vascular disease, but also to an alteration in autonomic control.
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Titapiccolo et al. (2012) conducted an observational in Hemodialysis with peripheral vascular disease. Peripheral vascular disease vs. Patients without peripheral vascular disease was evaluated on Blood pressure variability, heart rate variability, and baroreflex sensitivity. Peripheral vascular disease in hemodialysis patients was associated with altered autonomic control, including higher very low frequency diastolic blood pressure variability and reduced cardiac baroreflex.
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