Abstract
Objectives: Hemodialysis patients are at an increased risk of atherosclerotic complications. Brachial-ankle pulse-wave velocity (baPWV) is an indicator of atherosclerosis. In the present study, relationships between baPWV and various clinical parameters of atherosclerosis were investigated in patients on maintenance hemodialysis (HD). Materials and Methods: This study included 98 patients (67 males and 31 females) on maintenance HD with normal ABI (>0.9 and<1.3). BaPWV was measured using a volume-plethysmographic apparatus (form PWV/ABI, Omron Colin Co. Ltd. Japan). Predialysis and postdialysis blood samples were drawn during the same hemodialysis session for subsequent measurements. Kt/V and the protein catabolic rate (PCR) were calculated. Blood levels of 8-OHdG as a marker of oxidative stress, IL-6 as a pro-inflammatory cytokine, and fetuin-A as a calcification inhibitor, were determined by ELISA. The geriatric nutritional risk index (GNRI) was calculated as an index of the nutritional state. The erythropoiesis resistance index (ERI) was evaluated as an index of ESA hyporesponsiveness. Results: No significant difference in baPWV was observed between the sexes or between diabetic and non-diabetic nephropathy patients. BaPWV was significantly and positively correlated with age (p<0.001) and HD duration (p<0.05), and significantly and negatively correlated with body weight (p<0.005), BMI (p<0.05), serum albumin (p<0.005), GNRI (p<0.0001), and creatinine (p<0.005). BaPWV was found to have a significant positive correlation with LOG IL-6 (p<0.01). No significant correlations were found between baPWV and fetuin-A or 8-OHdG levels. BaPWV significantly and positively correlated with adjusted calcium concentrations (p<0.01) and β2-MG (p<0.01), but not with serum calcium levels or Kt/V, and significantly and negatively correlated with TIBC (p<0.05). BaPWV significantly and positively correlated with ERI (p<0.05). Conclusion: The present study suggests that baPWV may be associated with inflammation, nutritional state, age, HD duration, middle molecules, TIBC, adjusted calcium concentrations, and ERI.
