title: Changes in arterial stiffness following dialysis in relation to overhydration and to endothelial function.
abstract: BACKGROUND
  Cardiovascular (CV) morbidity and mortality are greatly enhanced in patients with chronic kidney disease, partly due to increased arterial stiffness.
  
  
  METHODS
  The study included 63 stable HD patients. Stiffness parameters were evaluated by applanation tonometry before the mid-week HD sessions. Pre-HD bioimpedance parameters were measured. A phase angle <six degrees was previously reported as abnormal, reflecting extracellular overhydration. Fluid status was evaluated echocardiographic by measuring the inferior vena cava (IVC) diameter. Endothelium-dependent and endothelium-independent vascular reactivity were assessed by changes in Alx following sublingual nitroglycerin and inhaled salbutamol.
  
  
  RESULTS
  PWV directly correlated with patients' age and dialysis vintage. Patients with a phase angle <6°, were significantly overhydrated (larger IVC, increased ECW, and lower ICW), had stiffer arteries and greater left ventricle mass (LVM), compared with those with a phase angle >6°. Overhydration increases arterial stiffness, but has no influence on either EID or ED vascular reactivity.
  
  
  CONCLUSIONS
  In hemodialysis, volume overload is an important contributor to increased arterial stiffness and modifies cardiovascular status especially by LV hypertrophy. Achieving normohydration may significantly ameliorate cardiac abnormalities and arterial stiffness and may impact major clinical events and CV mortality.
authors.affiliation: Clinic of Nephrology at C. I. Parhon University Hospital, Gr. T. Popa University of Medicine and Pharmacy, Bd. Carol I, Nr. 50, Iasi 700503, Romania. MMH1228@YAHOO.COM
authors.forename: Simona
authors.initials: S
authors.lastname: Hogas
authors.forename: Serban
authors.initials: S
authors.lastname: Ardeleanu
authors.forename: Liviu
authors.initials: L
authors.lastname: Segall
authors.forename: Dragomir Nicolae
authors.initials: DN
authors.lastname: Serban
authors.forename: Ionela Lacramioara
authors.initials: IL
authors.lastname: Serban
authors.forename: Mihai
authors.initials: M
authors.lastname: Hogas
authors.forename: Mugurel
authors.initials: M
authors.lastname: Apetrii
authors.forename: Mihai
authors.initials: M
authors.lastname: Onofriescu
authors.forename: Radu
authors.initials: R
authors.lastname: Sascau
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000494:pharmacology; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D001834:Body Water / Q000502:physiology*; D004452:Echocardiography; D017097:Electric Impedance; D004727:Endothelium / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015999:Multivariate Analysis; D005996:Nitroglycerin / Q000494:pharmacology; D011674:Pulse; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000628:therapy; D059289:Vascular Stiffness / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D014665:Vasodilator Agents; D005996:Nitroglycerin; D000420:Albuterol