%0 Journal Article
%T Membrane Bioincompatibility and Ultrafiltration Effects on Pulse Wave Analysis during Haemodialysis
%A Maria-Pau Valenzuela
%A Jaume Almirall
%A Mar¨ªa-Jos¨¦ Amengual
%J ISRN Nephrology
%D 2013
%R 10.5402/2013/892315
%X Membrane bioincompatibility was demonstrated by successive white blood cell counts and C3a generation. Pulse wave analysis was obtained by applanation tonometry (SphygmoCor) in a sequential way: basal, after 30 minutes with nul ultrafiltration, and after a complete dialysis with ultrafiltration. At 15 minutes of haemodialysis, significant decrease in leukocyte count occurred: versus ( ), while C3a levels sharply increased from to £¿ng/mL ( ). No changes were observed in augmentation index without ultrafiltration: versus . Only aortic systolic blood pressure was lower at 15 minutes: versus £¿mmHg ( ), in agreement with a reduction in brachial systolic blood pressure: versus £¿mmHg ( ), without changes in aortic or brachial diastolic blood pressure. Important changes in pulse wave analysis were observed after a complete haemodialysis session: augmentation index versus , aortic systolic blood pressure versus mmHg ( ), without changes in aortic diastolic blood pressure. In summary, haemodialysis with cellulose diacetate acutely induced a transient state of immunoactivation due to bioincompatibility, this phenomenon was nondetectable by pulse wave analysis. Complete haemodialysis session led to important changes in pulse wave analysis. 1. Introduction Cardiovascular (CV) disease is the main cause of morbidity and mortality in patients with end-stage renal disease (ESRD). The increased risk is partly due to a higher prevalence of traditional CV risk factors. Nevertheless, these patients also present other nontraditional CV risk factors related with the setting of uremic background [1] that result in functional and structural alterations of the arterial wall, leading to an increase in arterial stiffness. As in the general population, arterial stiffening has been described as an independent predictor of both CV and overall mortality in haemodialysis (HD) patients [2¨C8]. Another component that has been proposed to play a role in CV risk is the HD session per se. The dialysis procedure may induce acute functional alterations of the arterial wall through several mechanisms, the most remarkable being the intermittent immunoactivation state induced by dialysis [9¨C11], and the acute intravascular volume drop produced during the HD session [12¨C17]. It has been proposed that these acute functional alterations could be detected by noninvasive pulse wave analysis (PWA) [12]. As PWA measurements are being increasingly introduced in the clinical setting, the main objective of our study was to separately analyze the acute effects on PWA of bioincompatibility and
%U http://www.hindawi.com/journals/isrn.nephrology/2013/892315/