Hamsiah Diko

In order to ensure that they are reliable markers of atherosclerosis and suitable for repetitive follow-up of disease progression and management responses in hemodialysis (HD) patients, brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) should be tested to see whether they change with different measurement time points. The aim of this study was to assess whether baPWV and ABI vary according to whether they are measured before HD, after HD, or on the next dialysis-free day. Eighty-nine patients undergoing regular HD were enrolled. The baPWV and ABI were measured 10-30 min before and after HD, and if patients agreed, on the next dialysis-free day. The third measurement of baPWV and ABI, performed 22+/-2 h after HD, was taken in 72 patients (81%). The body weight reduction after HD was 2.5+/-0.9 kg (p<0.001). The brachial and ankle systolic and diastolic blood pressures before HD were significantly higher than those after HD and on the next dialysis-free day (p<or=0.038). Right and left baPWV increased significantly after HD (p<or=0.006), but returned to the pre-dialysis level on the next dialysis-free day. However, the right and left ABI remained constant before and after HD, or on the next dialysis-free day (p>or=0.498). In conclusion, despite the significant decrease in body weight and blood pressures, baPWV increased significantly after HD. In addition, baPWV, but not ABI, may vary at different measurement time points. Therefore, baPWV, but not ABI, should be assessed in a timely manner in HD patients.