Key result
Renal replacement therapy shows conflicting effects on arterial stiffness, with inconsistent changes in PWV.
Why the study?
The relationship between renal replacement therapy and arterial stiffness in end-stage renal disease patients remains controversial and inconsistent in the literature.
Conflicting RRT effects on arterial stiffness preclude practice changes; leaves open the need for definitive trials.
The increase of arterial stiffness has been to have a significant impact on predicting mortality in end-stage renal disease patients. Pulse wave velocity (PWV) is a noninvasive, reliable parameter of regional arterial stiffness that integrates the vascular geometry and arterial wall intrinsic elasticity and is capable of predicting cardiovascular mortality in this patient population. Nevertheless, reports on PWV in dialyzed patients are contradictory and sometimes inconsistent: some reports claim the arterial wall stiffness increases (i.e., PWV increase), others claim that it is reduced, and some even state that it augments in the aorta while it simultaneously decreases in the brachial artery pathway. The purpose of this study was to analyze the literature in which longitudinal or transversal studies were performed in hemodialysis and/or peritoneal dialysis patients, in order to characterize arterial stiffness and the responsiveness to renal replacement therapy.
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Fischer et al. (2015) conducted a review in End-stage renal disease (ESRD). Renal replacement therapy (hemodialysis and peritoneal dialysis) vs. Pre-dialysis patients, healthy controls, or different dialysis modalities was evaluated on Arterial stiffness measured by pulse wave velocity (PWV). The effects of renal replacement therapy on arterial stiffness remain controversial and multifactorial, with conflicting reports showing both increases and decreases in pulse wave velocity.
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