title: Endothelium-dependent vasodilatation and distensibility of large arteries in chronic haemodialysis patients.
abstract: BACKGROUND
  Cardiovascular mortality is increased in chronic haemodialysis (HD) patients and is not completely explained by common cardiovascular risk factors. Hyperhomocysteinaemia and chronic HD per se may play a role, because these factors may adversely affect endothelial function and distensibility of conduit arteries, which are important determinants of the risk of atherosclerosis, thrombosis and cardiac hypertrophy.
  
  
  METHODS
  A vessel wall movement detector system was used to investigate endothelium-dependent, flow-mediated and endothelium-independent, glyceryl trinitrate-induced vasodilatation in the brachial artery and compliance and distensibility coefficients (CC and DC) in the common carotid artery in 28 chronic HD patients and 28 control subjects.
  
  
  RESULTS
  Endothelium-dependent, but not endothelium-independent, vasodilatation was markedly reduced in the HD group (3.7 +/- 1.1 vs. 9.7 +/- 1.2%; P = 0.001). The DC was reduced only in a subgroup of patients aged < 50 years: 16.9 +/- 1.5 vs. 22.4 +/- 2.0 10(-3)/kPa (P = 0.032) and was not related to endothelium-dependent vasodilatation. CC did not differ between the groups. Plasma total homocysteine was elevated in the HD patients, but was neither related to endothelium-dependent vasodilatation, nor to DC.
  
  
  CONCLUSIONS
  Chronic renal failure and (or) chronic haemodialysis are associated with impaired endothelium-dependent vasodilatation, which may reflect an increased susceptibility for the development of atherosclerosis and thrombosis.
authors.affiliation: Department of Internal Medicine, Academic Hospital, Amsterdam, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: van Guldener
authors.forename: J
authors.initials: J
authors.lastname: Lambert
authors.forename: M J
authors.initials: MJ
authors.lastname: Janssen
authors.forename: A J
authors.initials: AJ
authors.lastname: Donker
authors.forename: C D
authors.initials: CD
authors.lastname: Stehouwer
mesh_terms: D000328:Adult; D001916:Brachial Artery / Q000503:physiopathology*; D017536:Carotid Artery, Common / Q000503:physiopathology*; D003187:Compliance; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013997:Time Factors; D014664:Vasodilation / Q000502:physiology*
chemical_list: D006710:Homocysteine