Impact of Anemia on Aortic Pulse Wave Velocity in Hemodialysis Patients

• Published in: Kidney & blood pressure research Vol. 32; no. 3; pp. 210 - 216
• Main Authors: Schwarz, Clemens Peter, Koppelstaetter, Christian, Amann, Edda, Mayer, Gert
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2009
• Subjects: Aged; Aged, 80 and over; Anemia - physiopathology; Aorta - physiology; Female; Hemoglobins - analysis; Humans; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Male; Middle Aged; Original Paper; Pulsatile Flow; Renal Dialysis; Risk Factors; Aortic pulse wave velocity; Anemia; Hemodialysis
• ISSN: 1420-4096; 1423-0143
• DOI: 10.1159/000227274

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 (β = 0.513, p < 0.001), mean blood pressure (β = 0.255, p = 0.01), the presence of heart failure (β = 0.188, p = 0.03), hemoglobin (β = –0.226, p = 0.01), daily calcium load (β = –0.230, p = 0.01) and the presence of diabetes mellitus (β = 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.