Fluid overload and vascular stiffness in hemodialysis patients

• Author / Creator

  Aya Lafta

• People requiring hemodialysis (HD) have a high cardiovascular mortality rate. Some of the strongest predictors for the increased cardiovascular disease is related to vascular stiffness and fluid overload. Nevertheless, there is an ongoing debate regarding the importance of fluid overload as an independent factor of vascular stiffness in HD patients. Currently, there are very limited reports that have investigated a correlation between fluid overload and vascular stiffness in HD patients. Therefore, we first explored the current literature by conducting a scoping review to identify all the clinical and epidemiological studies that researched in the similar area of research interest. Then, we performed a pilot observational study to have an impression on the vascular function during the inter- and intradialytic fluid overload changes in fluid overloaded and non-fluid overload HD patients. Fluid status and vascular stiffness were tested in 39 HD patients (20 with fluid overload and 19 without) and compared to 26 healthy controls. Pre-dialysis vascular stiffness measurements were performed for 24 hours and then for 5-hours: starting 30 minutes before and ending 30 minutes after the HD run. Afterward, we designed a randomized controlled trial, using bioimpedance spectroscopy and the time-averaged fluid overload measure, to correct the target weight in the fluid overloaded HD patients, foreseeing an improvement in fluid status and vascular stiffness. However, the study is still ongoing. Altogether, the accumulated results in the scoping review were conflicting as the size and power of the included studies were low, and the approaches varied widely. In the observational study, we found that the inter- and intradialytic changes in fluid overload do not seem a strong determinant of vascular stiffness. It is important to have larger studies to address the effect of fluid overload changes on vascular stiffness in HD patients.

• Subjects / Keywords

  • Fluid overload
  • Hemodialysis
  • Vascular stiffness

• Graduation date

  Fall 2020

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-jete-0933

• License

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