OBJECTIVE: In this study, we compared the changes in arterial stiffness in chronic hemodialysis patients treated with 8-h vs. 4-h thrice weekly in-center hemodialysis. METHODS: Sixty prevalent chronic hemodialysis patients assigned to 8-h nocturnal in-center thrice weekly HD (NHD) and 60 control cases assigned to 4-h thrice weekly conventional HD (CHD) were followed for one year. Radial-carotid pulse wave velocity, augmentation index and echocardiography were performed at baseline and 12th month. RESULTS: Mean age of the patients was 49±11 years, 30.8% were female, 27.5% had diabetes mellitus and mean dialysis vintage was 57±47 months. Baseline demographical, clinical and laboratory parameters were similar between groups. During a mean follow-up of 15.0±0.1 months, blood pressure remained similar in both groups while the number of mean daily anti-hypertensive substances decreased in the NHD group. In the NHD group, time-averaged serum phosphorus and calcium-phosphorus product were lower than the CHD group. Pulse wave velocity and augmentation index decreased in the NHD group (from 11.02±2.51 m/s to 9.61±2.39 m/s and from 28.8±10.3% to 26.2±12.1%; p=0.008 and p=0.04, respectively). While augmentation index increased in the CHD group (28.0±9.4 to 31.0±10.7%, p=0.02), pulse wave velocity did not change. Subendocardial viability ratio and ejection duration improved in the NHD group (from 135±28 to 143±25%, p=0.01 and from 294±34 ms to 281±34 ms, p=0.003, respectively), accompanied by regression of left ventricular mass index. In multiple stepwise linear regression analyses, NHD was associated with improvements in augmentation index, ejection duration and subendocardial viability ratio. CONCLUSIONS: These data indicate that arterial stiffness is ameliorated by implementation of longer hemodialysis sessions.
OBJECTIVE: In this study, we compared the changes in arterial stiffness in chronic hemodialysis patients treated with 8-h vs. 4-h thrice weekly in-center hemodialysis. METHODS: Sixty prevalent chronic hemodialysis patients assigned to 8-h nocturnal in-center thrice weekly HD (NHD) and 60 control cases assigned to 4-h thrice weekly conventional HD (CHD) were followed for one year. Radial-carotid pulse wave velocity, augmentation index and echocardiography were performed at baseline and 12th month. RESULTS: Mean age of the patients was 49±11 years, 30.8% were female, 27.5% had diabetes mellitus and mean dialysis vintage was 57±47 months. Baseline demographical, clinical and laboratory parameters were similar between groups. During a mean follow-up of 15.0±0.1 months, blood pressure remained similar in both groups while the number of mean daily anti-hypertensive substances decreased in the NHD group. In the NHD group, time-averaged serum phosphorus and calcium-phosphorus product were lower than the CHD group. Pulse wave velocity and augmentation index decreased in the NHD group (from 11.02±2.51 m/s to 9.61±2.39 m/s and from 28.8±10.3% to 26.2±12.1%; p=0.008 and p=0.04, respectively). While augmentation index increased in the CHD group (28.0±9.4 to 31.0±10.7%, p=0.02), pulse wave velocity did not change. Subendocardial viability ratio and ejection duration improved in the NHD group (from 135±28 to 143±25%, p=0.01 and from 294±34 ms to 281±34 ms, p=0.003, respectively), accompanied by regression of left ventricular mass index. In multiple stepwise linear regression analyses, NHD was associated with improvements in augmentation index, ejection duration and subendocardial viability ratio. CONCLUSIONS: These data indicate that arterial stiffness is ameliorated by implementation of longer hemodialysis sessions.
Authors: Jeffrey Perl; Sahir Kalim; Ron Wald; Marc B Goldstein; Andrew T Yan; Nazanin Noori; Mercedeh Kiaii; Julia Wenger; Christopher Chan; Ravi I Thadhani; S Ananth Karumanchi; Anders H Berg Journal: Hemodial Int Date: 2016-06-21 Impact factor: 1.812
Authors: Giuseppe Stefano Netti; Mario Rotondi; Adelaide Di Lorenzo; Domenico Papantonio; Antonino Teri; Morena Schirone; Federica Spadaccino; Laura Croce; Barbara Infante; Rossella Perulli; Francesca Coperchini; Maria Teresa Rocchetti; Giuseppina Iannelli; Francesca Fortunato; Rosa Prato; Giuseppe Castellano; Loreto Gesualdo; Giovanni Stallone; Elena Ranieri; Giuseppe Grandaliano Journal: Clin Kidney J Date: 2020-02-10