Changes in Flow-Mediated Vasodilation after a Single Session of Hemodialysis / 대한신장학회잡지

ABSTRACT

BACKGROUND: The cardiovascular morbidity and mortality are much higher in the patients who undergo hemodialysis than normal population. Atherosclerotic vascular disease is one of the most important causes of cardiovascular disease, and it is thought to be related to endothelial function. It is known that endothelial function in the end-stage renal disease (ESRD) patients is decreased, but it is not clear the hemodialysis can improve the endothelial function or not. Hemodialysis can remove uremic toxins and improve endothelial function, but it also can cause oxidative stress to vascular endothelial cell. The purpose of this study is to determine whether hemodialysis could improve endothelial function compared with simple ultrafiltration in the same patient. METHODS: We prospectively evaluated endothelial function of hemodialysis patients by flow-mediated vasodilation (FMD) method in the patient's right brachial artery. Total thirteen patients were enrolled in this study, and their right brachial artery diameters were measured by 7 MHz echocardiography probe, and calculated by enlarged scan image. FMD were measured before and after hemodialysis, and measured before and after simple ultrafiltration in the same patient, same four hours of each session. RESULTS: The mean brachial artery diameters were 4.18+/-1.11 mm in pre-hemodialysis and 4.25+/-1.15 mm in pre-ultrafiltration respectively, and there was no statistic difference. Average percent change of brachial artery diameter before and after hemodialysis were 2.20+/-1.67 and 1.35+/-1.22% (p<0.05). The same of ultrafiltration were 2.13+/-1.99 and 2.72+/-1.79% (p=0.431). CONCLUSION: In summary, flow mediated vasodilation after a single session of hemodialysis, in contrast with simple ultrafiltration, could be diminished significantly.