Impact of anemia on aortic pulse wave velocity in hemodialysis patients.

Background: Recent studies indicate an increased mortality of anemic patients with renal failure when near-normal hemoglobin levels are aimed for by treatment with erythropoiesis stimulating agents. Aortic pulse wave velocity (aPWV) is a strong predictor of all-cause and cardiovascular mortality in patients with end-stage renal disease. The relationships between aPWV, hemoglobin levels and erythropoiesis stimulating agent dosage have not been evaluated to date.

Methods: In 75 patients, aPWV was measured by applanation tonometry. Associations of aPWV and a broad range of clinical, laboratory and therapeutic parameters were determined by stepwise linear regression analysis.

Results: aPWV was positively correlated to age (r = 0.55, p < 0.001), whereas the association with hemoglobin was significant, but negative (r = -0.31, p = 0.01). Multivariate analysis determined age (beta = 0.513, p < 0.001), mean blood pressure (beta = 0.255, p = 0.01), the presence of heart failure (beta = 0.188, p = 0.03), hemoglobin (beta = -0.226, p = 0.01), daily calcium load (beta = -0.230, p = 0.01) and the presence of diabetes mellitus (beta = 0.179, p = 0.04) to have a significant and independent influence on aPWV.

Conclusions: This study demonstrates that in hemodialysis patients, aPWV is significantly but negatively associated with the serum hemoglobin concentration, even after multiple adjustments for other covariates.