Two years of maintenance hemodialysis has a pronounced effect on arterial stiffness progression

Abstract

Background: The change of aortic stiffness, but not the particular baseline value, plays a crucial role in estimating the patient risk with end-stage renal disease. Therefore, we aimed to analyze the evolution of central and peripheral arterial stiffness in hemodialysis population without previous cardiovascular events during a 2-year follow-up.

Methods: 60 hemodialysis patients (mean age 57.61 ± 13.01 years) were prospectively interviewed, and they underwent blood tests, chest X-ray for aortic calcification evaluation and pulse wave velocity (PWV) measurements at the baseline, after 6 months and after 2 years of observation period.

Results: We found significant progression of aortic PWV (12.73 vs. 14.24 m/s, p = 0.032) and regression of brachial PWV (11.53 vs. 8.85 m/s, p < 0.001). CRP increase influenced evolution of aortic PWV (β = 0.331, p = 0.031, R² = 0.599). Higher β2-microglobulin values was related to the progression of aortic PWV (β = 0.219, p = 0.022, R² = 0.568). Mean arterial blood pressure had influence only on the short-term arterial stiffness evolution.

Conclusions: Patients on maintenance hemodialysis experience pronounced changes of arterial stiffness during the 2-year follow-up period. The progression of aortic stiffness is related to inflammatory response and particularly is influenced by β2-microglobulin concentration and aortic calcification.

Keywords: Arterial stiffness; Dialysis; Progression; Pulse wave velocity; Vascular remodeling.