Power, A;
Charitaki, E;
Davenport, A;
(2016)
Haemodialysis and haemodiafiltration lead to similar changes in vascular stiffness during treatment.
International Journal of Artificial Organs
, 39
(5)
pp. 228-234.
10.5301/ijao.5000503.
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Abstract
BACKGROUND: Haemodiafiltration (HDF) has been reported to cause less hypotension than haemodialysis (HD). We hypothesized that HDF causes less change in vascular tone, thereby reducing hypotension. METHODS: Aortic pulse wave velocity (PWVao) was measured in 284 patients, during a single dialysis session using cooled dialysate (117 HD, 177 HDF). Patient groups were matched for age, sex and cardiovascular comorbidity. RESULTS: Systolic blood pressure (SBP) declined from 144 ± 26 to 133 ± 26 after 20 minutes, and to 131 ± 26 mmHg post HD, and for HDF from 152 ± 26 to 143 ± 27 after 20 minutes, then to 138 ± 27 mmHg post HDF. Net Ultrafiltration rates to achieve weight loss were similar; HD 0.13 ± 0.06 vs HDF 0.12 ± 0.05 mL/kg/min. PWVao did not change after 20 minutes HD 0.42(-0.7 to 1.3), HDF 0.5 (-0.6 to 1.8) or at the end of the session: HD -0.39 (1.5 to 1.2), HDF -0.41(-2.0 to 1.3) m/s. Aortic augmentation index (AiAxo), assessment of vascular tone fell significantly with both HD; 20 minutes by 6.2 (-2.5 to 14), end 5.6 (-6.7 to 13.9), and HDF 20 min by 4.2 (-2.5 to 10), end 7.8 (-0.8 to 19.3), with no difference between HD and HDF. The ultrafiltration rate correlated with % change in aortic SBP (r = 0.28 p = 0.004), but not with changes in PWVao or augmentation indices. CONCLUSION: Blood pressure declined during both HD and HDF treatments, as did augmentation indices, unrelated to weight loss, suggesting a reduction in vascular stiffness occurs independently of treatment modality. We did not observe an advantage for HDF.
| Type: | Article |
|---|---|
| Title: | Haemodialysis and haemodiafiltration lead to similar changes in vascular stiffness during treatment |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.5301/ijao.5000503 |
| Publisher version: | http://dx.doi.org/10.5301/ijao.5000503 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Technology, Life Sciences & Biomedicine, Engineering, Biomedical, Transplantation, Engineering, Hemodiafiltration, Hemodialysis, Pulse wave velocity, Pulse-wave Velocity, High-flux Hemodialysis, Blood-pressure, Intradialytic Hypotension, Online Hemodiafiltration, Augmentation Index, Sodium-gradient, Hemofiltration, Dialysis |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices 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/1501171 |
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