Microvascular dilatation after haemodialysis is determined by the volume of fluid removed and fall in mean arterial pressure.

Published

Journal Article

BACKGROUND/AIMS: The effects of haemodialysis on the microcirculation are poorly understood. This study examined the changes in small vessel calibre. METHODS: 24 patients (including 12 males, median age 62.5 years, range 30-87) underwent digital retinal photography immediately before and after routine haemodialysis. Arteriolar and venular calibres were measured from the images by a trained grader using a highly reproducible, computer-assisted method. RESULTS: Patients had an average 2.0 ± 0.3 litres of fluid removed with dialysis, and their mean arterial blood pressure fell by 6.8 mm Hg (CI 13.8-0.2, p = 0.06). Retinal arteriole calibre did not change (mean difference 2.3 µm, CI -1.1 to 5.7, p = 0.17) but the venules dilated (mean difference 12.7 µm, CI 7.3-18.3, p < 0.001). Calibre returned to baseline by 2 h. Venules dilated less in diabetics than non-diabetics (mean difference -6.2 µm, CI -9.6 to -2.9, p < 0.01). Retinal venular dilatation correlated positively with the volume of fluid removed per kilogramme body weight (5.9, CI 0.2-11.5, p = 0.04), and negatively with the fall in mean arterial pressure (-0.36, CI -0.72 to -0.01, p < 0.05) after adjusting for age, gender, diabetes and dyslipidaemia. CONCLUSION: Haemodialysis is associated with systemic venular dilatation.

Full Text

Duke Authors

Cited Authors

  • Tow, FKN-FH; Ooi, QL; Wong, TY; Kawasaki, R; Colville, D; Mount, P; Savige, J

Published Date

  • 2012

Published In

Volume / Issue

  • 35 / 6

Start / End Page

  • 644 - 648

PubMed ID

  • 23095519

Pubmed Central ID

  • 23095519

Electronic International Standard Serial Number (EISSN)

  • 1423-0143

Digital Object Identifier (DOI)

  • 10.1159/000341732

Language

  • eng

Conference Location

  • Switzerland