Arterial wave reflection is elevated in evening hemodialysis patients.
OBJECTIVE
Cardiovascular disease constitutes a major cause of death in patients with chronic kidney diseases and is related to enhanced arterial stiffness. It has been reported that daytime hemodialysis patients show better prognosis than evening hemodialysis patients.


METHODS
Aortic augmentation index (AI) and radial AI were measured in 20 non-diabetic hemodialysis patients, using SphygmoCor (PWV Medical) and HEM-9010AI (Omron Healthcare) as markers of arterial stiffness. Cardiovascular prognosis was followed for two years.


RESULTS
Mean age, blood pressure, pulse rate, and aortic and radial AI were 52 +/- 4 y/o, 142 +/- 6/74 +/- 4 mmHg, 78 +/- 4 bpm, 21 +/- 2, and 71 +/- 4%, respectively, in 10 daytime hemodialysis patients, and they averaged 52 +/- 3 y/o, 146 +/- 6/76 +/- 4 mmHg, 74 +/- 3 bpm, 26 +/- 2, and 73 +/- 3% in 10 evening hemodialysis patients, respectively. Thus, aortic AI was higher in evening hemodialysis patients (p < 0.05). In all, one patient was hospitalized due to cardiovascular complications in daytime hemodialysis patients, as well as three patients from those dialyzed in the evening.


CONCLUSIONS
Although a larger scale study is required to draw a definite conclusion, our findings suggest that a better prognosis in daytime hemodialysis non-diabetic patients is related to the lower AI.
Takenaka
Tsuneo
T
Department of Nephrology, Saitama Medical University, Iruma, Saitama, Japan.
Mimura
Taku
T
Kanno
Yoshihiko
Y
Ohno
Yoichi
Y
Suzuki
Hiromichi
H
D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000150:complications; D002908:Chronic Disease; D002940:Circadian Rhythm; D004548:Elasticity; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011673:Pulsatile Flow; D017534:Radial Artery / Q000503:physiopathology*; D006435:Renal Dialysis