Association of Arterial Stiffness with the Decrease of Post-Dialysis Blood Pressure in Maintained Hemodialysis Patients |
Mi Jung Shin, M.D., Byung Soo Kim, M.D., Young Ok Kim, M.D. Ho Cheol Song, M.D., Yong-Soo Kim, M.D., Suk Young Kim, M.D. Euy Jin Choi, M.D., Yoon Sik Chang, M.D. and Byung Kee Bang, M.D. |
Division of Nephrology, Department of Internal Medicine The Catholic University of Korea, Seoul, Korea |
원저 : Association of Arterial Stiffness with the Decrease of Post-Dialysis Blood Pressure in Maintained Hemodialysis Patients |
Mi Jung Shin, M.D., Byung Soo Kim, M.D., Young Ok Kim, M.D. Ho Cheol Song, M.D., Yong-Soo Kim, M.D., Suk Young Kim, M.D. Euy Jin Choi, M.D., Yoon Sik Chang, M.D. and Byung Kee Bang, M.D. |
Division of Nephrology, Department of Internal Medicine The Catholic University of Korea, Seoul, Korea |
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Abstract |
Purpose : Cardiovascular disease is one of the leading causes of mortality and morbidity in hemodialysis patients. Arterial stiffness is known to be associated with vascular calcification in HD patients. Post-dialysis hypotension is a risk factor for cardiovascular mortality. We evaluated the relation between arterial stiffness and post-dialysis blood pressure in maintained HD patients.
Methods : 72 HD patients were enrolled in this study. They had been under maintenance HD for more than 3 months. We checked the biochemical data, including the troponin T, CRP and OPG (osteoprotegerin) levels before their dialysis session and the baPWV (brachio-ankle pulse wave velocity) after the session. We defined post-dialysis BP decrease as a drop of BP of more than 5% of the average MAP for 2 weeks (6 sessions).
Results : There were 34 and 38 patients with and without post-dialysis BP decrease, respectively. The BP decrease group had higher CRP, troponin T and OPG levels (p<0.05, 0.01 and 0.01, respectively). The PWV was higher in the BP decrease group (p<0.001). The CRP and troponin T levels were positively correlated with the PWV (r=0.26, p<0.05; r=0.31, p<0.01, respectively). The OPG level was positively correlated with the PWV (r=0.44, p<0.001). Age, pre-dialysis pulse pressure and drops in the patients MAP were correlated with the PWV (r=0.33, p<0.05; r=0.31, p<0.05; r=0.30, p<0.05, respectively). On multivariate analysis, PWV was the independent factor related to the drops in the MAP of the patients (β=0.311, p=0.021).
Conclusion : Arterial stiffness is associated with post-dialysis blood pressure decrease.
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Key Words:
Dialysis, Hypotension, Atherosclerosis |
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