title: Aortic-Radial Pulse Wave Velocity Ratio in End-stage Renal Disease Patients: Association with Age, Body Tissue Hydration Status, Renal Failure Etiology and Five Years of Hemodialysis.
abstract: BACKGROUND
  The etiology of the end-stage renal disease (ESRD) and the hydration status may be involved in the arterial stiffening process observed in hemodialyzed patients. The ratio between carotid-femoral and carotid-radial pulse wave velocity (PWV ratio) was recently proposed to characterize the patient-specific stiffening process.
  
  
  OBJECTIVE
  to analyze: (1) the PWV-ratio in healthy and hemodialyzed subjects, analyzing potential changes associated to etiologies of the ESRD, (2) the PWV-ratio and hydration status using multiple-frequency bioimpedance and, (3) the effects of hemodialysis on PWV-ratio in a 5-year follow-up.
  
  
  METHODS
  PWV-ratio was evaluated in 151 patients differentiated by the pathology determining their ESRD. Total body fluid (TBF), intra and extra cellular fluid (ICF, ECF) were measured in 65 of these patients using bioelectrical-impedance. The association between arterial, hemodynamic or fluid parameters was analyzed. PWV-ratio was evaluated in a group of patients (n = 25) 5 years later (follow-up study).
  
  
  RESULTS
  PWV-ratio increased in the ESRD cohort with respect to the control group (1.03 ± 0.23 vs. 1.31 ± 0.37; p < 0.001). PWV-ratio in the diabetic nephropathy group was higher than in all other etiological groups (1.61 ± 0.33; p < 0.05). PWV-ratio was associated with TBF (r = -0.238; p < 0.05), ICF (r = -0.323; p < 0.01), ECF/ICF (r = 0.400; p < 0.001) and ECF/TBF (r = 0.403; p < 0.001). PWV-ratio calculated in ESRD patients in 2007 increased 5 years later (1.14 ± 0.32 vs. 1.43 ± 0.44; p < 0.005).
  
  
  CONCLUSIONS
  PWV-ratio increased the most in patients with diabetic nephropathy. PWV ratio was significantly associated with age and body hydration status, but not with the blood pressure. PWV-ratio could be considered a blood pressure-independent parameter, associated with the age and hydration status of the patient.
authors.affiliation: Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay. dbia@fmed.edu.uy.
authors.forename: Daniel
authors.identifier: http://orcid.org/0000-0001-7160-7166
authors.initials: D
authors.lastname: Bia
authors.affiliation: Fresenius FME Burzaco, Av. Tomás Espora 2289, B1852FZD, Buenos Aires, Argentina.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Valtuille
authors.affiliation: Nephrology and Dialysis Unit, Santojanni Hospital, Pilar 950, C1408INH, Buenos Aires, Argentina.
authors.forename: Cintia
authors.initials: C
authors.lastname: Galli
authors.affiliation: Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Solís 453, C1078AAI, Buenos Aires, Argentina.
authors.forename: Sandra
authors.initials: S
authors.lastname: Wray
authors.affiliation: Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Solís 453, C1078AAI, Buenos Aires, Argentina.|Technological National University, Medrano 951, C1179AAQ, Buenos Aires, Argentina.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Armentano
authors.affiliation: Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
authors.forename: Yanina
authors.initials: Y
authors.lastname: Zócalo
authors.affiliation: Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Solís 453, C1078AAI, Buenos Aires, Argentina.
authors.forename: Edmundo
authors.initials: E
authors.lastname: Cabrera-Fischer
mesh_terms: D000367:Age Factors; D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure; D001823:Body Composition; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D017534:Radial Artery / Q000503:physiopathology*; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D059289:Vascular Stiffness; D014882:Water-Electrolyte Balance
keywords: Arterial stiffness; Body hydration status; Hemodialysis; Pulse wave velocity ratio