Charitaki, E;
Davenport, A;
(2013)
Do higher dialysate calcium concentrations increase vascular stiffness in haemodialysis patients as measured by aortic pulse wave velocity?
BMC NEPHROLOGY
, 14
, Article 189. 10.1186/1471-2369-14-189.
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Abstract
Background: Haemodialysis patients have an increased prevalence of hypertension and risk of cardiovascular mortality and stroke. Higher dialysate calcium concentrations have been reported to cause both an acute and chronic increase in arterial stiffness. We therefore looked at changes in arterial stiffness in established haemodialysis patients to determine whether there was a threshold effect of dialysate calcium concentration linked to change in arterial stiffness. Methods: We performed pulse wave velocity measurements six months apart in patients dialysing with calcium concentrations of 1.0, 1.25, 1.35 and ≥1.5 mmol/l. Results: 289 patients, 62.2% male, mean age 65.5 ± 15.7 years, weight body mass index 25.8 ± 5.4 kg/m2 ,47.9% diabetic were studied. Systolic blood pressure (SBP) was 148.4 ± 28.6 mmHg and diastolic blood pressure (DBP) 80.2 ± 15.5 mmHg. Mean pulse wave velocity increased over time (9.66 ± 2.0 vs 10.13 ± 2.16 m/s; p < 0.001), but there was no change in aortic augmentation index (38.7 ± 16.3 vs 39.8 ± 15.6%) or central aortic pressure (149.6 ± 33.3 vs 150.4 ± 31.9 mmHg). Pulse wave velocity did not differ between the four groups either at start or end of the study, but increased both in the groups dialysing with a calcium concentration of 1.0 mmol/l (9.64 ± 1.94 vs 10.45 ± 1.98 m/s, p = 0.0028) and also with 1.35 mmol/l (9.75 ± 1.96 vs 10.21 ± 2.18 m/s, p = 0.02). Conclusions: Pulse wave velocity increased over the six months study. As pulse wave velocity increased in the group dialysing using the lowest dialysate calcium, it is likely that factors, other than simple net calcium influx and efflux during dialysis according to dialysate calcium concentration are involved with vascular stiffening.
| Type: | Article |
|---|---|
| Title: | Do higher dialysate calcium concentrations increase vascular stiffness in haemodialysis patients as measured by aortic pulse wave velocity? |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/1471-2369-14-189 |
| Publisher version: | http://dx.doi.org/10.1186/1471-2369-14-189 |
| Language: | English |
| Additional information: | © 2013 Charitaki and Davenport; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
| Keywords: | Hypertension, Haemodialysis, Dialysate calcium, Pulse wave velocity, Vascular calcification |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1410920 |
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