Abstract
In order to ensure that they are reliable markers of atherosclerosis and suitable for repetitive follow-up of disease progression and management responses in hemodialysis (HD) patients, brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) should be tested to see whether they change with different measurement time points. The aim of this study was to assess whether baPWV and ABI vary according to whether they are measured before HD, after HD, or on the next dialysis-free day. Eighty-nine patients undergoing regular HD were enrolled. The baPWV and ABI were measured 10–30 min before and after HD, and if patients agreed, on the next dialysis-free day. The third measurement of baPWV and ABI, performed 22±2 h after HD, was taken in 72 patients (81%). The body weight reduction after HD was 2.5±0.9 kg (p<0.001). The brachial and ankle systolic and diastolic blood pressures before HD were significantly higher than those after HD and on the next dialysis-free day (p≤0.038). Right and left baPWV increased significantly after HD (p≤0.006), but returned to the pre-dialysis level on the next dialysis-free day. However, the right and left ABI remained constant before and after HD, or on the next dialysis-free day (p≥0.498). In conclusion, despite the significant decrease in body weight and blood pressures, baPWV increased significantly after HD. In addition, baPWV, but not ABI, may vary at different measurement time points. Therefore, baPWV, but not ABI, should be assessed in a timely manner in HD patients.
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O'Hare A, Johansen K : Lower-extremity peripheral arterial disease among patients with end-stage renal disease. J Am Soc Nephrol 2001; 12: 2838–2847.
Shinzato T, Nakai S, Akiba T, et al: Report of the annual statistical survey of the Japanese Society for Dialysis Therapy in 1996. Kidney Int 1999; 55: 700–712.
Criqui MH, Langer RD, Froneck A, et al: Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med 1992; 326: 381–386.
Schroll M, Munck O : Estimation of peripheral atherosclerotic disease by ankle blood pressure measurements in a population study of 60 year old men and women. J Chron Dis 1981; 34: 261–269.
Newman AB, Tyrrell KS, Vogt MT, Kuller LH : Morbidity and mortality in hypertensive adults with a low ankle/arm blood pressure. JAMA 1993; 270: 487–489.
Fowkes FG, Honsley E, Cawood EH, Macintyre CC, Ruckley CV, Prescott RJ : Edinburgh Artery Study. Prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol 1991; 20: 384–391.
Boutouyrie P, Tropeano AI, Asmar R, et al: Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension 2002; 39: 10–15.
Lehmann ED : Clinical value of aortic pulse-wave velocity measurement. Lancet 1999; 354: 528–529.
Asmar R, Benetos A, Topouchian J, Laurent P, Pannier B, Brisac AM : Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies. Hypertension 1995; 26: 485–490.
Yamashina A, Tomiyama H, Takeda K, et al: Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002; 25: 359–364.
Ono K, Tsuchida A, Kawai H, et al: Ankle-brachial blood pressure index predicts all-cause and cardiovascular mortality in hemodialysis patients. J Am Soc Nephrol 2003; 14: 1591–1598.
Kitahara T, Ono K, Tsuchida A, et al: Impact of brachial-ankle pulse wave velocity and ankle-brachial blood pressure index on mortality in hemodialysis patients. Am J Kidney Dis 2005; 46: 688–696.
Yamashina A, Tomiyama H, Arai T, et al: Nomogram of the relation of brachial-ankle pulse wave velocity with blood pressure. Hypertens Res 2003; 26: 801–806.
Nakamura U, Iwase M, Nohara S, Kanai H, Ichikawa K, Iida M : Usefulness of brachial-ankle pulse wave velocity measurement: correlation with abdominal aortic calcification. Hypertens Res 2003; 26: 163–167.
Li B, Gao H, Li X, Liu Y, Wang M : Correlation between brachial-ankle pulse wave velocity and arterial compliance and cardiovascular risk factors in elderly patients with arteriosclerosis. Hypertens Res 2006; 29: 309–314.
Su HM, Lee KT, Chu CS, et al: Effects of heart rate on brachial-ankle pulse wave velocity and ankle-brachial pressure index in patients without significant organic heart disease. Angiology 2007; 58: 67–74.
Lantelme P, Mestre C, Lievre M, Gressard A, Milon H : Heart rate: an important confounder of pulse wave velocity assessment. Hypertension 2002; 39: 1083–1087.
Yokoyama H, Shoji T, Kimoto E, et al: Pulse wave velocity in lower-limb arteries among diabetic patients with peripheral arterial disease. J Atheroscler Thromb 2003; 10: 253–258.
Suzuki E, Kashiwagi A, Nishio Y, et al: Increased arterial wall stiffness limits flow volume in the lower extremities in type 2 diabetic patients. Diabetes Care 2001; 24: 2107–2114.
Tomiyama H, Yamashina A, Arai T, et al: Influences of age and gender on results of noninvasive brachial-ankle pulse wave velocity measurement—a survey of 12517 subjects. Atherosclerosis 2003; 166: 303–309.
Nakao M, Nomura K, Karita K, Nishikitani M, Yano E : Relationship between brachial-ankle pulse wave velocity and heart rate variability in young Japanese men. Hypertens Res 2004; 27: 925–931.
Himmelfarb J, Stenvinkel P, Ikizler TA, Hakim RM : The elephant in uremia: oxidant stress as a unifying concept of cardiovascular disease in uremia. Kidney Int 2002; 62: 1524–1538.
Witko-Sarsat V, Gausson V, Descamps-Latsche B : Are advanced oxidation protein products potential uremic toxin. Kidney Int 2003; 63: S11–S14.
Kosch M, Levers A, Barenbrock M, et al: Acute effects of haemodialysis on endothelial function and large artery elasticity. Nephrol Dial Transplant 2001; 16: 1663–1668.
Mourad A, Carney S, Gillies A, Jones B, Nanra R, Trevillian P : Acute effect of haemodialysis on arterial stiffness: membrane bioincompatibility? Nephrol Dial Transplant 2004; 19: 2797–2802.
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Su, HM., Chang, JM., Lin, FH. et al. Influence of Different Measurement Time Points on Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Index in Hemodialysis Patients. Hypertens Res 30, 965–970 (2007). https://doi.org/10.1291/hypres.30.965
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DOI: https://doi.org/10.1291/hypres.30.965
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