Table 4.
Changes in endothelial cell function, arterial stiffness, and BP among those with and without resolution of intradialytic hypertension
| Baseline | Study End | Mean Change from Baseline to Study End | P Value | |
|---|---|---|---|---|
| Resolution of intradialytic hypertension (n=15) | ||||
| endothelial-dependent FMD (%) | 1.00 (±0.78) | 1.37 (±0.91) | 0.55 (±0.96) | 0.05 |
| endothelial progenitor cell markers | ||||
| ALDHbr (% of mononuclear cells) | 0.026 (0.013, 0.093) | 0.027 (0.012, 0.051) | 0.001 (−0.048, 0.016) | 0.6 |
| CD34+CD133+ (% of mononuclear cells) | 0.033 (0.016, 0.076) | 0.042 (0.016, 0.049) | 0.001 (−0.014, 0.012) | 0.9 |
| ET-1 (pg/ml) | ||||
| prehemodialysis | 4.76 (±1.52) | 5.20 (±1.67) | 0.36 (±2.02) | 0.5 |
| posthemodialysis | 5.79 (±2.94) | 4.87 (±2.34) | −1.02 (±3.40) | 0.3 |
| Δ hemodialysis | 1.04 (±2.83) | −0.34 (±1.90) | −1.38 (±4.45) | 0.3 |
| asymmetric dimethylarginine (µmol/L) | 0.70 (±0.19) | 0.63 (±0.19) | −0.08 (±0.15) | 0.07 |
| pulse wave velocity (m/s) | 12.4 (±3.5) | 11.8 (±3.0) | −0.6 (±2.2) | 0.3 |
| ambulatory BP (mmHg) | ||||
| systolic | 159.3 (±13.8) | 152.4 (±15.4) | −6.9 (±20.0) | 0.2 |
| diastolic | 84.1 (±9.8) | 78.4 (±7.7) | −5.0 (±9.6) | 0.07 |
| target dry weight | 81.5 (±21.7) | 81.3 (±22.9) | −0.1 (±3.9) | 0.9 |
| Persistent intradialytic hypertension (n=10) | ||||
| endothelial-dependent FMD (%) | 1.06 (±0.58) | 1.43 (±0.77) | 0.37 (±0.94) | 0.2 |
| endothelial progenitor cell markers | ||||
| ALDHbr (% of mononuclear cells) | 0.045 (0.031, 0.058) | 0.031 (0.016, 0.045) | −0.006 (−0.029, −0.001) | 0.5 |
| CD34+CD133+ (% of mononuclear cells) | 0.035 (0.019, 0.05) | 0.025 (0.019, 0.049) | −0.006 (−0.034, −0.022) | 0.8 |
| ET-1 (pg/ml) | ||||
| prehemodialysis | 5.26 (±2.57) | 6.19 (±3.06) | 0.09 (±1.46) | 0.8 |
| posthemodialysis | 6.22 (±3.09) | 6.96 (±3.50) | 0.42 (±1.28) | 0.4 |
| Δ hemodialysis | 0.96 (±1.57) | 0.77 (±2.17) | −0.33 (±2.23) | 0.7 |
| ADMA (µmol/L) | 0.65 (±0.15) | 0.70 (±0.14) | 0.03 (±0.10) | 0.4 |
| PWV (m/s) | 10.7 (±2.20) | 11.3 (±3.55) | 0.1 (±1.9) | 0.8 |
| ambulatory BP (mmHg) | ||||
| systolic | 149.5 (±13.3) | 141.1 (±15.6) | −8.4 (±11.7) | 0.05 |
| diastolic | 79.8 (±12.3) | 76.7 (±12.4) | −3.1 (±4.0) | 0.04 |
| target dry weight | 82.1 (±18.2) | 81.9 (±18.3) | −0.2 (±0.9) | 0.5 |
Values are reported as mean ± SD or medians and 25th to 75th interquartile ranges. Vasodilation units are the percentage of dilation and endothelial progenitor cells are the percentage of mononuclear cells. P values determined from paired t tests or nonparametric signed rank. FMD was normalized for peak shear rate and calculated as (FMD/peak shear rate) × 100 (21). Two PWV measurements were unable to be performed for technical reasons, two patients had inadequate samples for ET-1, and four patients had inadequate samples for ADMA. FMD, flow-mediated vasodilation; ALDHbr, aldehyde dehydrogenase activity; ET-1, endothelin-1; ADMA, asymmetric dimethylarginine; PWV, pulse wave velocity.