Author/Authors :
Keshtkari, Sara Department of Internal Medicine - Aja University of Medical Sciences (AJAUMS), Tehran, Iran - Labbafinejad Hospital - Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran , Hajibaratali, Bahareh Department of Cardiology - Labbafinejad Medical Center - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Parsa Mahjoob, Mohammad Cardiovascular Research Center - School of Medicine - Shahid Beheshti University of Medical Sciences, Tehran, Iran , dalili, Nooshin Chronic Kidney Disease Research Center - Shahid Beheshti University of Medical Sciences, Tehran, Iran - Department of Nephrology - Shahid Labbafinejad Medical Center - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Samavat, Shiva Chronic Kidney Disease Research Center - Shahid Beheshti University of Medical Sciences, Tehran, Iran - Department of Nephrology - Shahid Labbafinejad Medical Center - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Ahmadpour, Pedram Chronic Kidney Disease Research Center - Shahid Beheshti University of Medical Sciences, Tehran, Iran - Department of Nephrology - Shahid Labbafinejad Medical Center - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Ashrafi, Sadra Student Research Committee - Chronic Kidney Disease Research Center (CKDRC) - Shahid Beheshti University of Medical Siences, Tehran, Iran , Shahrezaei, Mostafa Department of Orthopedic Surgery - Faculty of Medicine - AJA University of Medical Science, Tehran, Iran , Khoshdel, Ali Reza Clinical Epidemiology Department - School of Medicine - AJA University of Medical Sciences, Tehran, Iran
Abstract :
Introduction. Cardiovascular disease is considered as the main cause of mortality and morbidity in HD-patients and AS is a fundamental cause. This study was conducted to investigate whether
intradialytic BP changes can use as a surrogate clinical marker.
Methods. Fifty-one patients on maintenance hemodialysis, for at least 12 hours per week, were included in a prospective cohort
study. Intradialytic BP was measured using validated automated
device. PWV was performed to assess Augmentation Index (AIx) as
marker of arterial stiffness. All measurements were repeated in alive
individuals after 5 years of follow-up. Patients with 5% reduction
of intradialytic BP were considered as HD-responsive and Several
statistical analyses were employed based on responsiveness to HD.
Results. After 5-year follow-up the findings demonstrated BP
response to HD was an important and independent determinant of
mortality (P < .05). Augmentation index (AIx) (P < .05), heart rate
(P < .05), and calcium phosphate product (P < .05) as well as log
PTH (P < .05) were significantly different between two responsive
and non-responsive to HD. Pearson’s Correlation studies revealed
a significant relationship between the BP response to HD and heart
rate (r = 0.4, P < .05), LVEF (r = -0.4, P < .05) and PTH (r = -0.3,
P < .05). BP response to HD and log-PTH remained significant
even after age and gender adjustment (P < .05).
Conclusion. BP-response to HD can use as a clinical and surrogate
marker of AS which is significantly associated with mortality and LVEF. Arterial stiffness and intradialytic BP can predict the changes in Ejection Fraction (EF).
