8.5 HEMODYNAMICS DURING INTRA- AND INTERDIALYTIC PERIODS DEPEND ON ULTRAFILTRATION VOLUME

DOI

10.1016/j.artres.2016.10.061How to use a DOI?

Abstract

Introduction: Parameters of arterial stiffness are independent cardiovascular risk factors for end-stage renal disease patients. Significant changes of these parameters between intra- and interdialytic periods have been reported previously [1]. The aim of this cross-sectional study is to describe the influence of the ultrafiltration volume on hemodynamic parameters.

Methods: All measurements were obtained with the Mobil-O-Graph 24h PWA (I.E.M. GmbH, Germany) within the ISAR hemodialysis study. Measurement started before the midweek dialysis session and lasted for 24-hours. 348 patients (238 male / 110 female 65 +- 18 years) were included. Intra- and interdialytic parameters were averaged and compared for three subgroups (ultrafiltration volume (UFV) <= 500 ml (N = 50) 500 < UFV< = 2000 ml (N = 159) UFV > 2000 ml (N = 139)) and all subjects.

Results: The results for all patients support the findings of Karpetas et al. [1] (see Table). Beyond [1], the results underpin the differences between subgroups for intra- and interdialytic periods. Furthermore, there are significant differences between intra- and interdialytic periods depending on the ultrafiltration volume (see Table). Exemplarily, there is a significant rise in the augmentation index (26.0 vs. 28.5%, p < 0.05) for UFV > 2000 ml and for central pulse pressure (39.6 vs. 43.4 mmHg and 36.0 vs. 38.3, p < 0.05) for UFV <= 2000 ml opposed to non-significance for the other subgroups.

Conclusions: Our findings support the hypothesis that hemodynamic parameters depend on ultrafiltration volume. Further studies should investigate their prognostic value considering the ultrafiltration volume.

	UFV <= 500 ml			500 < UFV <= 2000 ml			UFV > 2000 ml			All
	In		Out	In		Out	In		Out	In		Out
pSBP (mmHg)	128.9		131.0	123.7		122.3	124.5		123.0	124.8		123.8
pDBP (mmHg)	75.9		74.5	74.9		72.3	75.6		73.1	75.3	*	72.9
pPP (mmHg)	53.0		56.5	48.8		50.0	478.8		49.9	49.4		50.9
HR (bpm)	69.4		70.2	68.1	*	70.8	71.8		73.7	69.8	*	71.9
cSBP (mmHg)	116.9		119.3	112.4		111.9	113.4		112.6	113.4		113.2
cDBP (mmHg)	77.3		75.9	76.3		73.6	77.2		74.6	76.8	*	74.3
cPP (mmHg)	39.6	*	43.4	36.0	*	38.3	36.2		38.0	36.6	**	38.9
AIx (%)	29.7		31.8	29.5		30.2	26.0	*	28.5	28.1	*	29.8
AIx75 (%)	26.4		28.8	25.5	*	27.7	24.0	**	27.6	25.1	**	27.8
PWV (m/s)	10.03		10.14	9.88		9.85	9.08		9.07	9.58		9.58

Abbreviations: peripheral diastolic blood pressure (pDBP), peripheral systolic blood pressure (pSBP), peripheral pulse pressure (pPP), heart rate (HR), central diastolic blood pressure (cDBP), central systolic blood pressure (cSBP), peripheral pulse pressure (pPP), augmentation index (AIx, AIx75) and pulse wave velocity (PWV)

*/**

marks a significant difference between intra- and interdialytic periods (p < 0.05 and p < 0.01, respectively).

Table:

Averaged hemodynamic parameters for intra- and interdialytic periods (In vs. Out) for different subgroups based on ultrafiltration volume (UF) and all subjects.

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TY  - JOUR
AU  - Christopher Mayer
AU  - Stephan Geilert
AU  - Julia Matschkal
AU  - Uwe Heemann
AU  - Marcus Baumann
AU  - Christoph Schmaderer
PY  - 2016
DA  - 2016/11/24
TI  - 8.5 HEMODYNAMICS DURING INTRA- AND INTERDIALYTIC PERIODS DEPEND ON ULTRAFILTRATION VOLUME
JO  - Artery Research
SP  - 66
EP  - 66
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.061
DO  - 10.1016/j.artres.2016.10.061
ID  - Mayer2016
ER  -