血液透析患者的透析液钠含量、流动主动脉血压和动脉僵硬度。

IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Adamantia Bratsiakou, Marieta Theodorakopoulou, Fotini Iatridi, Pantelis Sarafidis, Christos Davoulos, Dimitrios S Goumenos, Evangelos Papachristou, Marios Papasotiriou
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引用次数: 0

摘要

背景:主动脉血压(BP)和动脉僵化的增加与血液透析中较高的心血管风险有关。以前的研究表明,透析液钠浓度越低,肱动脉血压越低;而有关主动脉血压和动脉僵化的数据却很有限。本研究旨在调查不同透析液钠浓度对血液透析患者 72 小时主动脉血压和动脉僵化参数的影响:本分析是一项前瞻性非随机干预研究的一部分。25 名血液透析患者接受了三组不同透析液钠浓度的透析;六次透析液钠浓度为 137meq/L,之后连续六次透析液钠浓度为 139meq/L,最后六次透析液钠浓度为 141meq/L。在每种钠浓度的第六次血液透析开始时,进行 72 小时 ABPM(Mobil-O-Graph),以评估整个 72 小时、不同 24 小时、白天和夜间的主动脉血压和动脉僵化指数:结果:72小时平均主动脉SBP/DBP随着透析液钠浓度的增加而升高(137meq/L:114.2±15.3/77.0±11.8mmHg vs 139meq/L:115.4±17.3/77.9±14.0mmHg vs 141meq/L:120.5±18.4/80.5±14.7mmHg,分别为p=0.002/p=0.057)。波反射参数(AIx、AIx(75)、AP)在三种透析液钠浓度之间无明显差异。随着透析液钠浓度的增加,动态脉搏波速度明显增加(137meq/L:8.5±1.7m/s vs 139meq/L:8.6±1.6m/s vs 141meq/L:8.8±1.6m/s,p结论:本研究表明,较低的透析液钠浓度与活动主动脉血压和脉搏波速度的显著下降有关。该研究表明,透析液钠浓度越高,动态主动脉血压和脉搏波速度就越快。这些发现进一步支持了调整血液透析中透析液钠浓度的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dialysate Sodium Levels, Ambulatory Aortic Blood Pressure, and Arterial Stiffness in Hemodialysis Patients.

Background: Increased aortic blood pressure (BP) and arterial stiffness are associated with higher cardiovascular risk in hemodialysis. Previous works showed that lower dialysate sodium is associated with lower brachial-BP; data on aortic-BP and arterial stiffness are limited. This study aimed to investigate the effects of different dialysate sodium concentrations on 72-hour aortic-BP and arterial stiffness parameters in hemodialysis patients.

Methods: This analysis is part of a prospective, non-randomized interventional study. Twenty-five hemodialysis patients underwent a set of 3 periods of different dialysate sodium concentrations; 6 sessions with dialysate sodium of 137 mEq/l, followed consecutively by 6 sessions with 139 mEq/l and, finally, 6 sessions with 141 mEq/l. At the start of the sixth hemodialysis session on each sodium concentration, 72-hour ABPM (Mobil-O-Graph) was performed to evaluate aortic-BP and arterial stiffness indices during the overall 72-hour, different 24-hour, daytime, and nighttime periods.

Results: Mean 72-hour aortic systolic blood pressure (SBP)/diastolic blood pressure (DBP) were higher with increasing dialysate sodium concentrations (137 mEq/l: 114.2 ± 15.3/77.0 ± 11.8 mm Hg vs. 139 mEq/l: 115.4 ± 17.3/77.9 ± 14.0 mm Hg vs. 141 mEq/l: 120.5 ± 18.4/80.5 ± 14.7 mm Hg, P = 0.002/P = 0.057, respectively). Wave-reflection parameters (AIx, AIx(75), AP) were not significantly different between the 3 dialysate sodium concentrations. Ambulatory pulse wave velocity (PWV) was significantly higher with increasing dialysate sodium concentrations (137 mEq/l: 8.5 ± 1.7 m/s vs. 139 mEq/l: 8.6 ± 1.6 m/s vs. 141 mEq/l: 8.8 ± 1.6 m/s, P < 0.001). In generalized linear mixed models including 72-hour brachial SBP as a random covariate, the adjusted marginal means of 72-hour PWV were not significantly different between groups.

Conclusions: This study showed that higher dialysate sodium concentrations are associated with significant increases in ambulatory aortic BP and PWV. These findings further support the need for modification of dialysate sodium concentration in hemodialysis.

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来源期刊
American Journal of Hypertension
American Journal of Hypertension 医学-外周血管病
CiteScore
6.90
自引率
6.20%
发文量
144
审稿时长
3-8 weeks
期刊介绍: The American Journal of Hypertension is a monthly, peer-reviewed journal that provides a forum for scientific inquiry of the highest standards in the field of hypertension and related cardiovascular disease. The journal publishes high-quality original research and review articles on basic sciences, molecular biology, clinical and experimental hypertension, cardiology, epidemiology, pediatric hypertension, endocrinology, neurophysiology, and nephrology.
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