Risk Factors Of Arterial Stiffness In Maintenance Hemodialysis Patients

Objective To study the relationship between anemia and arterial stiffness in maintenance hemodialysis (MHD)patients.Methods Eighty-two clinical stable MHD patients with the exception of diabetic nephropathy were enrolled.Based on the level of hemoglobin (Hb),they were divided into two groups:fourty-five patients with Hb<10g/dL in group A, thirty-seven patients with Hb≥10g/dL in group B. IMT of carotid artery was examined by high-resolution B-mode ultrasonograph in all patients. The clinical characteristics and Kt/V of MHD patients were collected. Plasma malondialdehyde (MDA), superoxide dismutase(SOD) and other biochemical parameters were measured. Pearson's correlation and Backward multiple regression analysis were performed to identify the relationship between hemoglobin and IMT of carotid artery.Results IMT, SBP, PPand MDA in group A patients were significantly higher than those of group B patients (P<0.01),the SOD and albumin were lower than those of group B patients (P<0.01). Significant correlations were found between hemoglobin and MDA (r=-0.567, P=0.000) as well as SOD(r=0.482, P=0.000). Significant correlations were found between IMT and age (r=0.658, P=0.000), SBP (r=0.441, P=0.000).hemoglobin (r=-0.398, P=0.000), albumin(r=-0.483, P=0.000), MDA(r=0.278, P=0.011). Bac kward multiple regression analysis demonstrated that IMT were independently determined by age, hemoglobin, SBP and albumin level (R2=0.646, P<0.001)Conclusions Anemia was closely associated with IMT of carotid artery in MHD patients. Anemia was an independent risk factor for increased carotid artery IMT in MHD patients. Anemia may aggravate arterial stiffness through oxidative stress. Objective To study the assosiation between interdialytic weight gain and arterial stiffness in maintenance hemodialysis (MHD)patients.Methods A cross-sectional study was carried out in 82 MHD patients. IMT of carotid artery was examined by high-resolution B-mode ultrasonograph in all patients. Brachial blood pressure and biochemical parameters were measured.Pulse pressure(PP)was calculated as systolic blood pressure (SBP) minus diastolic blood pressure (DBP). Interdialytic weight gain were collected for ten times respectively, interdialytic weight gain/dry weight(IWG/DW) was used as an index of volume status. Pearson's correlation and Backward multiple regression analysis were performed to identify the relationship between IWG/DW and IMT.Results Pearson's correlation showed that IWG/DW was strongly associated with SBP (r=0.431, P=0.000),PP (r=0.379, P=0.000) and IMT (r= 0.411, P=0.000). Backward multiple regression analysis demonstrated that IMT were independently determined by age (β=0.712, P=0.000), IWG/DW(β=0.351, P=0.000)and diabetes mellitus (β=0.199, P=0.02). Conclusion IWG/DW was positively associated with IMT and PP in MHD patients. IWG/DW, in addition to age and diabetes mellitus, was an independent risk factor for elevated IMT in MHD patients, suggesting that increased arterial stiffness might be the link between fluid overload and cardiovascular events and mortality in MHD patients.