Korean Journal of Nephrology 2008;27(1):102-109.
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
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.
Key Words: Dialysis, Hypotension, Atherosclerosis


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