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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

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Abstract

Introduction

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. Aims: 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.

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Authors and Affiliations

  1. Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay

    Daniel Bia & Yanina Zócalo

  2. Fresenius FME Burzaco, Av. Tomás Espora 2289, B1852FZD, Buenos Aires, Argentina

    Rodolfo Valtuille

  3. Nephrology and Dialysis Unit, Santojanni Hospital, Pilar 950, C1408INH, Buenos Aires, Argentina

    Cintia Galli

  4. Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Solís 453, C1078AAI, Buenos Aires, Argentina

    Sandra Wray, Ricardo Armentano & Edmundo Cabrera-Fischer

  5. Technological National University, Medrano 951, C1179AAQ, Buenos Aires, Argentina

    Ricardo Armentano

Authors
  1. Daniel Bia
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  2. Rodolfo Valtuille
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  3. Cintia Galli
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  4. Sandra Wray
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  5. Ricardo Armentano
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  6. Yanina Zócalo
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  7. Edmundo Cabrera-Fischer
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Corresponding author

Correspondence to Daniel Bia.

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Funding

This study was funded by the René Favaloro University Foundation and funds of “PICT 2008 OC AR 0340” (Argentina) and Agencia Nacional de Investigación e Innovación (ANII; PRSCT-008-020).

Conflict of Interest

Author Dr. Daniel Bia declares that he has no conflict of interest. Dr. Rodolfo Valtuille declares that he has no conflict of interest. Dr. Cintia Galli declares that she has no conflict of interest. M.Sc. Sandra Wray declares that she has no conflict of interest. Dr. Ricardo Armentano declares that he has no conflict of interest. Dr. Yanina Zócalo declares that she has no conflict of interest. Dr. Edmundo Cabrera-Fischer declares that he has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Bia, D., Valtuille, R., Galli, C. et al. 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. High Blood Press Cardiovasc Prev 24, 37–48 (2017). https://doi.org/10.1007/s40292-017-0178-3

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  • DOI: https://doi.org/10.1007/s40292-017-0178-3

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