Variation of hemodialysis related arterial stiffness in patients with end stage renal disease

Objective: Cardiovascular disease is the leading cause of morbidity and mortality in patients undergoing hemodialysis. Increased arterial stiffness is an independent predictor of cardiovascular mortality in end stage renal disease (ESRD). We hypothesized that the hemodialysis procedure itself, through alterations in electrolytes and blood volume, could contribute to the increased cardiovascular risk encountered in ESRD. Material and methods: 28 chronic hemodialysis patients were evaluated before and after hemodialysis. We determined serum calcium, arterial stiffness (using pulse wave analysis) and hemodynamic parameters. Results: Serum calcium increased significantly during the dialysis treatment (P<0.01). Also, significant increase in stiffness index occurred at the end of dialysis (P=0.02). Both increments were correlated with ultrafiltration. No significant changes in systolic blood pressure, diastolic blood pressure or heart rate were noticed during hemodialysis. Arterial stiffness significantly increased after hemodialysis, unrelated to hemodynamic parameters. Conclusion: This vascular response may be an explanation for greater vulnerability regarding cardiovascular events in ESRD patients.