Increasing Dialysis Sodium Removal on Arterial Stiffness and Left Ventricular Hypertrophy in Hemodialysis Patients.

Objective: The aim of the present study was to examine the effects of a mild increase in dialysis sodium removal on cardiovascular system in hypertensive hemodialysis (HD) patients.

Methods: Sixty four HD patients with pre-HD plasma sodium level higher than 138mmol/l, were randomly assigned into 2 groups. The dialysate sodium was reduced from 138mmol/l to 136mmol/l in the intervention group, while remained at 138mmol/l in the control group.

Efficacy of losartan for improving insulin resistance and vascular remodeling in hemodialysis patients.

Insulin resistance and vascular remodeling are prevalent and predict cardiovascular mortality in hemodialysis patients. Angiotensin II (Ang II) may be involved in both pathogenesis. In the present study, we investigated the effects of the Ang II receptor blocker losartan on insulin resistance, arterial stiffness, and carotid artery structure in hemodialysis patients.

Is the dialysate calcium concentration of 1.75 mmol/L suitable for Chinese patients on maintenance hemodialysis?

We studied the effects of increasing the dialysate calcium concentration (DCa) to 1.75 mmol/L on controlling chronic kidney disease-mineral and bone disorder in Chinese patients on maintenance hemodialysis (MHD). We reviewed the data of MHD patients in one center (cohort 1) during prior 10 years and analyzed the risk factors of mortality and transference calcification (TC) in120 MHD patients surviving in 2003 (cohort 2).

Impact of dry weight determined by calf bioimpedance ratio on carotid stiffness and left ventricular hypertrophy in hemodialysis patients.

Our previous study has shown that modification of bioimpedance technique by the measurement of bioimpedance ratio in the calf (calf-BR) was a simple and practical method in assessing fluid status in hemodialysis patients. However, the consequences of periodical dry weight (DW) adjustment under the guidance of calf-BR on target organ damage have not been investigated. One hundred fifteen hemodialysis patients were enrolled in this pilot trial.

Effects of increasing diffusive sodium removal on blood pressure control in hemodialysis patients with optimal dry weight.

Background: Sodium, apart from volume, may have an independent effect on blood pressure (BP) regulation.

Methods: Sixteen hypertensive hemodialysis patients were enrolled, who have achieved their dry weight assessed by bioimpedance methods, with pre-dialysis plasma sodium levels slightly higher than the facility dialysate sodium concentration 138 mmol/l. After a 1-month period of dialysis with standard dialysate sodium concentration of 138 mmol/l, the patients were followed up for a 4-month period with dialysate sodium set at 136 mmol/l.

Comparison of ultrasound echo-tracking technology and pulse wave velocity for measuring carotid elasticity among hemodialysis patients.

This study aims to investigate the correlation between carotid elasticity in hemodialysis patients as evaluated by ultrasound echo-tracking technology and aortic pulse wave velocity. A total of 103 patients with end-stage renal disease who underwent stable hemodialysis were enrolled. An ultrasonic echo-tracking method was used to evaluate the elastic modulus and the stiffness index (β), which were compared with pulse wave velocity (PWV).

Calf bioimpedance ratio improves dry weight assessment and blood pressure control in hemodialysis patients.

Background: Chronic fluid overload due to overestimation of dry weight (DW) is the major factor in the development of hypertension in hemodialysis (HD) patients. The present study was undertaken to investigate whether bioimpedance ratio in the calf (Calf-BR = impedance at 200 kHz/impedance at 5 kHz) could be a useful hydration marker for estimation of DW and facilitate better control of blood pressure (BP) in HD patients.

Methods: Target range of Calf-BR was derived from 157 healthy Chinese subjects.

Association of serum pentosidine with arterial stiffness in hemodialysis patients.

Pentosidine is an advanced glycation end product (AGE). The present study was undertaken to investigate the association of serum pentosidine with carotid distensibility as a measure of arterial stiffness in hemodialysis patients. One hundred and three patients on maintenance hemodialysis were recruited.

Impact of sodium and ultrafiltration profiling on haemodialysis-related hypotension.

Background: Symptomatic hypotension is the most frequent complication in patients receiving haemodialysis (HD). Previous studies have reported that the use of modulating dialysate sodium concentration or ultrafiltration (UF) rates, or the combination use of sodium profile and UF profile may better preserve blood volume and reduce the incidence of hypotensive episodes. The aim of this study was to evaluate the effects of sodium balance-neutral sodium profile and UF profile and their combination on preservation of blood volume, cardiac function and occurrence of hypotensive episodes.