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Title: Microvascular dilatation after haemodialysis is determined by the volume of fluid removed and fall in mean arterial pressure
Authors: Tow, F.K.N.-F.H.
Ooi, Q.L.
Wong, T.Y. 
Kawasaki, R.
Colville, D.
Mount, P.
Savige, J.
Keywords: Dialysis
End-stage renal failure
Nitric oxide
Issue Date: Feb-2013
Citation: Tow, F.K.N.-F.H., Ooi, Q.L., Wong, T.Y., Kawasaki, R., Colville, D., Mount, P., Savige, J. (2013-02). Microvascular dilatation after haemodialysis is determined by the volume of fluid removed and fall in mean arterial pressure. Kidney and Blood Pressure Research 35 (6) : 644-648. ScholarBank@NUS Repository.
Abstract: 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. Copyright © 2012 S. Karger AG, Basel.
Source Title: Kidney and Blood Pressure Research
ISSN: 14204096
DOI: 10.1159/000341732
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