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动脉僵硬度：血液透析与血液透析滤过对比

Arterial stiffness: hemodialysis versus hemodiafiltration.

作者信息

Ghigolea Adrian-Bogdan, Gherman-Caprioara Mirela, Moldovan Argentina Raluca

机构信息

Nephrology Unit, Alba County Emergency Hospital, Alba-Iulia, Romania.

Nefromed Dialysis Centers, Alba-Iulia, Romania.

出版信息

Clujul Med. 2017;90(2):166-170. doi: 10.15386/cjmed-699. Epub 2017 Apr 25.

DOI:10.15386/cjmed-699
PMID:28559700
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5433568/
Abstract

BACKGROUND AND AIMS

Arterial stiffness seems to be influenced by the dialysis method, but studies are sparse and the results discordant. High substitution volume online hemodiafiltration appears to have beneficial cardiovascular effects in dialysis patients, but its effects on arterial stiffness are not investigated. We aimed to analyze arterial stiffness parameters in high substitution volume post-dilution online hemodiafiltration and compare results to high-flux hemodialysis.

METHODS

We studied arterial stiffness parameters using the oscillometric method (Arteriograph IrDA, TensioMed, Budapest, Hungary) in 23 non-diabetic patients on high substitution volume online postdilution hemodiafiltration and 23 non-diabetic patients on high-flux hemodialysis. Dialysis vintage was at least 6 months in all subjects.

RESULTS

Hemodiafiltration-treated patients showed a more favorable arterial stiffness profile. Pulse wave velocity was significantly higher in hemodialysis compared to hemodiafiltration patients (10.39±2.29 m/s vs 9.0±1.7 m/s, p=0.026). Augmentation indexes and the diastolic reflection area were also significantly elevated hemodialysis patients compared to hemodiafiltration patients.

CONCLUSIONS

High substitution volume online postdilution hemodiafiltration could have a beneficial effect on arterial stiffness and should be assessed in properly sized controlled trials.

摘要

背景与目的

动脉僵硬度似乎受透析方式影响，但相关研究较少且结果不一致。高置换量联机血液透析滤过对透析患者似乎具有有益的心血管效应，但其对动脉僵硬度的影响尚未得到研究。我们旨在分析高置换量后置稀释联机血液透析滤过中的动脉僵硬度参数，并将结果与高通量血液透析进行比较。

方法

我们使用示波法（Arteriograph IrDA，TensioMed，匈牙利布达佩斯）研究了23例接受高置换量后置稀释联机血液透析滤过的非糖尿病患者和23例接受高通量血液透析的非糖尿病患者的动脉僵硬度参数。所有受试者的透析龄均至少为6个月。

结果

接受血液透析滤过治疗的患者表现出更有利的动脉僵硬度特征。与血液透析滤过患者相比，血液透析患者的脉搏波速度显著更高（10.39±2.29米/秒对9.0±1.7米/秒，p = 0.026）。与血液透析滤过患者相比，血液透析患者的增强指数和舒张期反射面积也显著升高。

结论

高置换量后置稀释联机血液透析滤过可能对动脉僵硬度有有益影响，应在适当规模的对照试验中进行评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee94/5433568/e4b75fdb4367/cm-90-166f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee94/5433568/4d80213458d1/cm-90-166f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee94/5433568/a5a209b66bfc/cm-90-166f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee94/5433568/cf90ed66b9ad/cm-90-166f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee94/5433568/e4b75fdb4367/cm-90-166f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee94/5433568/4d80213458d1/cm-90-166f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee94/5433568/a5a209b66bfc/cm-90-166f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee94/5433568/cf90ed66b9ad/cm-90-166f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee94/5433568/e4b75fdb4367/cm-90-166f4.jpg

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