According to previous studies different parameters characterize arterial stiffness relate to cardiovascular mortality in patients on haemodialysis. However, its relative prognostic value and the optimal time of measurement have not previously been examined in one cohort.

The carotid-femoral pulse wave velocity (PWV), the carotid augmentation index (AI), the carotid pulse pressure (CPP) and the carotid-brachial pulse pressure amplification (AMP) were determined in 98 patients before and after haemodialysis procedure. Patients were followed for 29 months (median; range 1–34) and the association of these parameters with the risk of cardiovascular mortality was assessed using log-rank tests and Cox proportional hazards regression.

During follow-up, 25 patients died of cardiovascular causes. Increasing pre- and postdialysis PWV tertiles and decreasing predialysis AMP tertiles were significantly related to cardiovascular mortality (p = 0.012 and 0.011 for PWV, respectively; and <0.001 for AMP). Neither the AI nor CPP was related to cardiovascular mortality. The adjusted hazard ratios for 1 m/s higher pre- and postdialysis PWV were 1.24 (1.07–1.44) and 1.17 (1.06–1.28), respectively. The hazard ratio for 10% lower predialysis AMP was 1.41 (1.03–1.92). When included in the same model, both predialysis PWV and AMP remained significantly associated with cardiovascular mortality.

Among different stiffness parameters, PWV is consistently related to cardiovascular mortality, irrespectively of the timing of measurement. Predialysis AMP seems to provide additional prognostic information.

Supported by the Hungarian Society of Hypertension, Hungarian Society of Nephrology, Hungarian Nephrology Foundation.