Acute improvement of aortic mechanics following hemodialysis in patients with chronic renal failure.

Background: Evidence suggests that distensibility of the aorta is decreased in patients with end-stage renal failure, while the underlying mechanisms are unclear. Hypothesis: The purpose of the study was to evaluate the distensibility of the aorta in patients at the end stage of chronic renal failure before and after hemodialysis (HD). Methods: The diameter of the ascending aorta and distensibility were assessed in 48 patients on HD (31 men, 17 women, aged 45 ± 14 years) and in 27 normal subjects (17 men, 10 women, aged 44 ± 14 years). The diameter of the aorta was evaluated by M-mode in the parasternal long-axis view. Conclusions: Aortic distensibility in patients with end-stage renal disease is significantly lower than in normal subjects, and it is significantly improved after HD. Results: Aortic distensibility was significantly lower in patients on HD before HD (1.9 ± 0.7 cm2·dyn−110−6) than in normal control subjects (3.8 ± 1.0 cm2·dyn−1 106, p< 0.0001). After dialysis, it increased to 2.6 ± 1.2 (p < 0.05 compared with baseline, p < 0.001 compared with controls). The change of aortic distensibility correlated with age (R2 = 0.629 p < 0.001) and ultrafiltration volume (R2 = 0.168, p < 0.01).