Ambulatory recording of wave reflections and arterial stiffness during intra- and interdialytic periods in XXXX treated with dialysis.

@entity1 @entity6 @entity122 @entity454
BACKGROUND AND OBJECTIVES: Wave reflections and arterial stiffness are independent cardiovascular risk factors in @entity454 . Previous studies in this population included only static recordings before and after dialysis. This study investigated the variation of these indices during intra- and interdialytic intervals and examined demographic, clinical, and hemodynamic variables related to arterial function in @entity1 undergoing hemodialysis. DESIGN, SETTING, @entity1 , _ MEASUREMENTS: Between February 2013 and May 2014, a total of 153 @entity1 receiving maintenance hemodialysis in five dialysis centers of northern Greece underwent ambulatory BP monitoring with the newly introduced Mobil-O-Graph device (IEM, Stolberg, Germany) over a midweek dialysis session and the subsequent interdialytic period. Mobil-O-Graph is an oscillometric device that records brachial BP and pulse waves and estimates, via generalized transfer function, aortic BP, augmentation index (AIx) as a measure of wave reflections, and pulse wave velocity ( @entity122 ) as an index of arterial stiffness. RESULTS: AIx was lower during dialysis than in the interdialytic period of dialysis-on day (Day 1) (mean  SD, 24.7%  9.7% versus 26.8%  9.4%; P<0.001). In contrast, @entity122 remained unchanged between these intervals (9.31  2.2 versus 9.29  2.3 m/sec; P=0.60). Both AIx and @entity122 increased during dialysis-off day (Day 2) versus the out-of-dialysis period of Day 1 (28.8%  9.8% versus 26.8%  9.4% [P<0.001] and 9.39  2.3 versus 9.29  2.3 m/sec [P<0.001]). Older age (odds ratio [OR], 1.09; 95% confidence interval [95% CI], 1.02 to 1.15), female sex (OR, 7.56; 95% CI, 1.64 to 34.81), @entity6 status (OR, 8.84; 95% CI, 1.76 to 17.48), and higher mean BP (OR, 1.17; 95% CI, 1.09 to 1.27) were associated with higher odds of high AIx; higher heart rate was associated with lower odds (OR, 0.71; 95% CI, 0.63 to 0.80) of high AIx. Older age (OR, 2.04; 95% CI, 1.61 to 2.58) and higher mean BP (OR, 1.15; 95% CI, 1.05 to 1.27) were independent correlates of high @entity122 . CONCLUSIONS: This study showed a gradual interdialytic increase in AIx, whereas @entity122 was only slightly elevated during Day 2. Future studies are needed to elucidate the value of these ambulatory measures for cardiovascular risk prediction in @entity454 .
