Charitaki Evangelia, Davenport Andrew
UCL Centre for Nephrology, University College London Medical School, London, UK.
Hemodial Int. 2014 Apr;18(2):391-5. doi: 10.1111/hdi.12119. Epub 2013 Dec 3.
Hemodialfiltration (HDF) has been reported to reduce the frequency of intradialytic hypotension compared with hemodialysis (HD). We wished to determine whether HDF resulted in improvement of arterial stiffness compared with HD. We reviewed peripheral blood pressure and pulse wave velocity measurements in a cross-sectional analysis of stable HDF and HD outpatients. One hundred forty-one HDF patients were matched to 148 HD patients in terms of age, sex, prevalence of diabetes, peripheral blood pressure, and body mass. Pulse wave velocity was not different between the HD and HDF cohorts (median 9.1 [8.0-10.7] m/s vs. 9.7 [8.5-11.6] m/s). Similarly, there were no differences in central aortic pressure (149.2 ± 30.9 mmHg vs. 151.9 ± 35.2 mmHg), or aortic (39 [25.1-51.2]% vs. 38.6 [25.8-51.4]%) and brachial (3.8 [-24.3 to 26.9]% vs. 3 [-22.4 to 27.1]%) augmentation indices, respectively. Pulse wave velocity did not differ between adult patients treated by HD and HDF, and similarly, there were no differences in central aortic pressure, aortic or brachial augmentation indices, and cardiac diastolic perfusion. Our study suggests that HDF does not appear to offer any benefit over HD in terms of vascular stiffness.
据报道，与血液透析（HD）相比，血液透析滤过（HDF）可降低透析期间低血压的发生率。我们希望确定与HD相比，HDF是否能改善动脉僵硬度。我们回顾了稳定的HDF和HD门诊患者的横断面分析中的外周血压和脉搏波速度测量值。141例HDF患者在年龄、性别、糖尿病患病率、外周血压和体重方面与148例HD患者相匹配。HD组和HDF组之间的脉搏波速度没有差异（中位数9.1[8.0-10.7]m/s对9.7[8.5-11.6]m/s）。同样，中心主动脉压（149.2±30.9mmHg对151.9±35.2mmHg）、主动脉（39[25.1-51.2]%对38.6[25.8-51.4]%）和肱动脉（3.8[-24.3至26.9]%对3[-22.4至27.1]%）增强指数也没有差异。HD和HDF治疗的成年患者之间的脉搏波速度没有差异，同样，中心主动脉压、主动脉或肱动脉增强指数以及心脏舒张灌注也没有差异。我们的研究表明，在血管僵硬度方面，HDF似乎并不比HD有任何优势。
