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Low dialysate potassium and central arterial pressure waveform
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Renal Medicine.
2015 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 120, no 3, 207-212 p.Article in journal (Refereed) Published
Abstract [en]

Background. Cardiovascular mortality is high in hemodialysis (HD) patients. Early arterial pressure wave reflections predict mortality in HD patients, and HD acutely improves the central pressure waveform. Potassium (K) plays a crucial role in cardiac electrophysiology, and patients with end-stage kidney disease depend on HD for neutral K balance. We aimed to study the impact of dialysate K concentrations on central arterial pressure waveform. Methods. Thirty-three chronic HD patients were studied before and after a HD session, and the prescribed dialysate K concentration was recorded. In a subset of 23 patients without arrhythmias, pulse wave analysis was performed on radial arteries. Nine patients had dialysate K set to 1 mmol/L (group 1), and 14 patients had K set to 2 or 3 mmol/L (group 2). Augmentation index (AIx), defined as difference between the second and first systolic peak divided by central pulse pressure, was used as a measure of arterial stiffness. Results. HD reduced the AIx in group 1 only (p = 0.0005). Likewise, central systolic pressure was reduced in group 1 only (p = 0.006). The relative reduction of AIx post-HD was significantly higher in group 1 compared with group 2 (p < 0.0001). The association between low dialysate K and AIx reduction remained statistically significant after adjustment for variables including the change in central and peripheral systolic pressure and mean arterial pressure. Conclusion. Low dialysate K is strongly and independently associated with the acute improvement of AIx.

Place, publisher, year, edition, pages
2015. Vol. 120, no 3, 207-212 p.
Keyword [en]
central pressure augmentation, hemodialysis, potassium
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:uu:diva-261992DOI: 10.3109/03009734.2015.1037031ISI: 000359819800008PubMedID: 25951045OAI: oai:DiVA.org:uu-261992DiVA: diva2:851856
Available from: 2015-09-07 Created: 2015-09-07 Last updated: 2017-12-04Bibliographically approved

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Soveri, Inga

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