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Hypocholesterolemia is a risk factor for reduced systemic vascular resistance reactivity during hemodialysis

Abstract

Intradialytic hypotension (IDH) is associated with high mortality. Peripheral vascular resistance and circulating blood volume are important factors in IDH; however, the effects of hemodialysis (HD) on vascular resistance in IDH remain unclear. We herein performed a retrospective observational cohort study to investigate changes in and factors related to vascular resistance during HD. A total of 101 HD patients were divided into two groups (Decreased blood pressure (BP) during HD group: N = 19, Nondecreased BP group: N = 82), and cardiac output was measured with electrical velocimetry (AESCLON) for 3 h. The systemic vascular resistance index (SVRI) was significantly decreased in the Decreased BP group, while the cardiac index was similar in both groups. A multivariate regression analysis identified hypocholesterolemia as a predictor of reduced vascular resistance reactivity during HD. Furthermore, a correlation was found between changes in the SVRI and cholesterol levels in patients with a higher Geriatric Nutritional Risk Index (GNRI) but not in those with a lower GNRI. The present results suggest that hypocholesterolemia contributes to reducing systematic vascular resistance reactivity during HD, which is an important predictor of a reduction in BP during HD. The relationship between hypocholesterolemia and vascular resistance may involve mechanisms other than malnutrition.

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Acknowledgements

We thank Yoko Saito and Chie Nishiguchi for their excellent assistance. This study was supported by a 2019 Novartis Research Grant.

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Correspondence to Fumiki Yoshihara.

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Matsuo, M., Kojima, S., Arisato, T. et al. Hypocholesterolemia is a risk factor for reduced systemic vascular resistance reactivity during hemodialysis. Hypertens Res 44, 988–995 (2021). https://doi.org/10.1038/s41440-021-00640-2

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Keywords

  • Vascular resistance
  • Dyslipidemia
  • Malnutrition
  • Hemodialysis

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