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Jung JH, Chae YJ, Lee DH, Cho YI, Ko MM, Park SK, Kim W. Changes in whole blood viscosity during hemodialysis and mortality in patients with end-stage renal disease. Clin Hemorheol Microcirc 2017; 65:285-297. [DOI: 10.3233/ch-16183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Jong Hwan Jung
- Department of Internal Medicine, Divsion of Nephrology, Wonkwang University College of Medicine, Iksan, Republic of Korea
| | - Yoon Jung Chae
- College of Nursing, Chonbuk National University, Jeonju, Republic of Korea
| | - Dong Hwan Lee
- Department of Mechanical Design Engineering, Engineering College, Chonbuk National University, Jeonju, Republic of Korea
| | - Young I. Cho
- Department of Mechanical Engineering and Mechanics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Mi Mi Ko
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sung Kwang Park
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Won Kim
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Republic of Korea
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BUYAN N, AKÇABOY M, GÖKTAŞ T, KULA S, NAZLIEL B, ÇAKAR N, UNCU N, ÇELİK B, ERBAŞ D. Effects of whole blood viscosity and plasma NOx on cardiac function and cerebral blood flow in children with chronic kidney disease. Turk J Med Sci 2017; 47:1482-1491. [DOI: 10.3906/sag-1609-33] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Xu H, Ärnlöv J, Sandhagen B, Risérus U, Lindholm B, Lind L, Carrero JJ. Lipophilic index, kidney function, and kidney function decline. Nutr Metab Cardiovasc Dis 2016; 26:1096-1103. [PMID: 27773469 DOI: 10.1016/j.numecd.2016.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/17/2016] [Accepted: 09/04/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Unhealthy dietary fats are associated with faster kidney function decline. The cell membrane composition of phospholipid fatty acids (FAs) is a determinant of membrane fluidity and rheological properties. These properties, which have been linked to kidney damage, are thought to be reflected by the lipophilic index (LI). We prospectively investigated the associations of LI with kidney function and its decline. METHODS AND RESULTS Observational study from the Prospective Investigation of Vasculature in Uppsala Seniors including 975 men and women with plasma phospholipid FAs composition and cystatin-C estimate glomerular filtration rate (eGFR). Of these, 780 attended re-examination after 5 years, and eGFR changes were assessed. Participants with a 5-year eGFR reduction ≥30% were considered chronic kidney disease (CKD) progressors (n = 198). LI was calculated as the sum of the products of the FA proportions with the respective FAs melting points. Blood rheology/viscosity measurements were performed in a random subsample of 559 subjects at baseline. Increased LI showed a statistically significant but overall weak association with blood, plasma viscosity (both Spearman rho = 0.16, p < 0.01), and erythrocyte deformability (rho = -0.09, p < 0.05). In cross-sectional analyses, LI associated with lower eGFR (regression coefficient 3.00 ml/min/1.73 m2 1-standard deviation (SD) increment in LI, 95% CI: -4.31, -1.69, p < 0.001). In longitudinal analyses, LI associated with a faster eGFR decline (-2.13 [95% CI -3.58, -0.69] ml/min/1.73 m2, p < 0.01) and with 32% increased odds of CKD progression (adjusted OR 1.32 [95%, CI 1.05-1.65]). CONCLUSIONS A high LI was associated with lower kidney function, kidney function decline, and CKD progression.
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Affiliation(s)
- H Xu
- Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
| | - J Ärnlöv
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden
| | - B Sandhagen
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - U Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - B Lindholm
- Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
| | - L Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - J J Carrero
- Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
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Fontana F, Ballestri M, Makomi C, Morandi R, Cappelli G. Hemorheologic alterations in peritoneal dialysis. Clin Hemorheol Microcirc 2016; 65:175-183. [PMID: 27340762 DOI: 10.3233/ch-16152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dialysis patients present a cardiovascular risk substantially higher than general population, due to both traditional and non-traditional risk factors. Hemorheologic alterations have been extensively described in hemodialysis patients (HD), while little data on hemorheology exist about peritoneal dialysis patients (PD). Aim of our study is to characterize the hemorheological profile of 49 PD, and to compare these data with HD and healthy volunteers. PD showed an improvement of parameters related to macro-circulation (plasma viscosity, whole blood viscosity at 1-Hz, erythrocyte aggregation index and yield stress) when compared to HD, while microcirculatory function resulted severely impaired, as expressed by high values for whole blood viscosity 200-Hz shear rate and lower erythrocyte deformability (ED). In conclusion, we found hemorheologic alterations in PD, with substantial differences with respect to HD; in particular, PD showed profound dysfunction in microcirculatory flow with impaired ED. This alterations may act as a risk factor for accelerated atherosclerosis and precipitate cardiovascular events, and it may have a detrimental effect in the peritoneal microcirculation promoting endothelial activation with subsequent fibrosis, leading to peritoneal membrane malfunctioning.
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Affiliation(s)
- Francesco Fontana
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Ballestri
- Divisione di Nefrologia, Dialisi e Trapianto Renale, Dipartimento di Medicina e Specialitá Mediche, Policlinico di Modena, Modena, Italy
| | - Clarisse Makomi
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Morandi
- Department of Oncology and Haematology, Section of Transfusion Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianni Cappelli
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy
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Celik T, Yilmaz MI, Balta S, Ozturk C, Unal HU, Aparci M, Karaman M, Demir M, Yildirim AO, Saglam M, Kilic S, Eyileten T, Aydin İ, Iyisoy A. The Relationship Between Plasma Whole Blood Viscosity and Cardiovascular Events in Patients With Chronic Kidney Disease. Clin Appl Thromb Hemost 2016; 23:663-670. [PMID: 26907084 DOI: 10.1177/1076029616634888] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Plasma levels of estimated whole blood viscosity (eWBV) have been increased by endothelial inflammation. Because there were no consistent data for assessing the eWBV levels for prediction of cardiovascular event (CVE) in patients with chronic kidney disease (CKD). We aimed to investigate the relationship between plasma eWBV levels and CVEs in patients with CKD. MATERIALS AND METHODS We conducted a prospective, cross-sectional, long-term follow-up study, assessing the relationship between plasma eWBV levels and CVE (either fatal or nonfatal) in patients with newly diagnosed CKD. We also evaluated estimated glomerular filtration rate (eGFR), pentraxin 3 (PTX3), high-sensitivity C-reactive protein (hsCRP), and flow-mediated dilatation (FMD). RESULTS Study patients were divided into 2 groups: patients with CVE and patients without CVE. The eWBV levels were higher in patients with CVE. Additionally, PTX3 and hsCRP were higher, and FMD and eGFR were lower in patients with CVE compared to those without CVE. According to the Cox regression analysis, WBV, plasma asymmetric dimethylarginine levels, FMD, hsCRP, eGFR, systolic blood pressure, calcium, and history of diabetes were independent predictors of CVEs in patients with CKD. Kaplan Meier survival curves were generated to establish the impact of the WBV on the cumulative survival of the cohort. Patients with eWBV values higher than 5.2 centipoise (cP) had lower survival rates when compared to patients with eWBV values lower than 5.2 cP (log rank = 4.49 df = 1 P = .034). CONCLUSION In conclusion, plasma eWBV levels may increase the presence of lower eGFR and affect CVE in patients with CKD independent of classical and unconventional risk factors.
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Affiliation(s)
- Turgay Celik
- 1 Department of Cardiology, Gulhane School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Mahmut Ilker Yilmaz
- 2 Department of Nephrology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Sevket Balta
- 1 Department of Cardiology, Gulhane School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Cengiz Ozturk
- 1 Department of Cardiology, Gulhane School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Hilmi Umut Unal
- 2 Department of Nephrology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Mustafa Aparci
- 3 Department of Cardiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Uskudar-Istanbul, Turkey
| | - Murat Karaman
- 2 Department of Nephrology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Mustafa Demir
- 1 Department of Cardiology, Gulhane School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - A Osman Yildirim
- 1 Department of Cardiology, Gulhane School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Mutlu Saglam
- 4 Department of Radiology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Selim Kilic
- 5 Department of Epidemiology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Tayfun Eyileten
- 2 Department of Nephrology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - İbrahim Aydin
- 6 Department of Clinical Biochemistry, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
| | - Atila Iyisoy
- 1 Department of Cardiology, Gulhane School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey
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Silva C, Reis AH. Structure and adaptation of arteries to pulsatile flow: the case of the ascending aorta. Med Phys 2015; 41:063701. [PMID: 24877840 DOI: 10.1118/1.4876379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The objectives are: (i) assess the development of the impedance of some arteries during the first decades of life; (ii) determine the influence of pulse rate in arterial impedance; (iii) compare the structure of some arterial segments with optimized structures with respect to blood flow; and (iv) explain the elongation of the ascending aorta throughout life in healthy subjects. METHODS A model of the arterial network previously developed by the authors, together with data of lengths, diameters, and distensibilities of arterial segments reported in the literature were used. The impedances of the aorta and carotid artery were calculated based on that model. Similarly, the impedances of various arteries corresponding to heart rates of 65 bpm and 120 bpm were calculated. Values observed in arterial segments were compared with the respective optimal values from the viewpoint of hemodynamic performance. This allowed drawing conclusions on the arterial segments that might be critical with regard to hemodynamics. RESULTS It was found that in healthy people impedances of the aorta and the carotid artery decrease markedly with age especially during body growth. It was also found that impedances of the main arteries do not significantly change with heart rate, even if sharp changes in arterial distensibility are observed. With respect to optimal flow performance, it was found that scaling between diameters of branching arteries is generally close to optimality, while the corresponding length scaling is far from optimality. It was also found that the ascending aorta and aortic arch are among those arterial segments whose lengths are much smaller than the optimum values. An explanation is offered for the age associated elongation of the aorta in healthy people. CONCLUSIONS In healthy subjects, the human arterial system continues to optimize its performance at least until the age of 60.
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Affiliation(s)
- Carla Silva
- Polytechnic Institute of Tomar, Qta. do Contador, 2300-313 Tomar, Portugal and Évora Geophysics Centre, R. Romão Ramalho, 59, 7000-671 Évora, Portugal
| | - A Heitor Reis
- Évora Geophysics Centre, R. Romão Ramalho, 59, 7000-671 Évora, Portugal and Physics Department, University of Évora, R. RomãoRamalho, 59, 7000-671 Évora, Portugal
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Amraoui F, Olde Engberink RHG, van Gorp J, Ramdani A, Vogt L, van den Born BJH. Microvascular Glycocalyx Dimension Estimated by Automated SDF Imaging is not Related to Cardiovascular Disease. Microcirculation 2014; 21:499-505. [DOI: 10.1111/micc.12125] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Accepted: 02/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Fouad Amraoui
- Department of Vascular Medicine; Academic Medical Center; Amsterdam The Netherlands
| | | | - Jacqueline van Gorp
- Department of Vascular Medicine; Academic Medical Center; Amsterdam The Netherlands
| | - Amal Ramdani
- Department of Vascular Medicine; Academic Medical Center; Amsterdam The Netherlands
| | - Liffert Vogt
- Department of Nephrology; Academic Medical Center; Amsterdam The Netherlands
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Changes in Whole Blood Viscosity at Low Shear Rates Correlate with Intravascular Volume Changes during Hemodialysis. Int J Artif Organs 2012; 35:425-34. [PMID: 22669590 DOI: 10.5301/ijao.5000107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2012] [Indexed: 11/20/2022]
Abstract
Background: Elevated blood viscosity has been shown to be independently correlated with cardiovascular risk factors and associated with increased risk of major cardiovascular events, including death and acute myocardial infarction. The aim of the present study was to investigate changes in whole blood viscosity (WBV) at shear rates of 1, 5, and 300 s-1 before and after hemodialysis in patients with end-stage renal disease (ESRD). We also examined the relationship between the changes of WBV and intravascular blood volume. Methods: 43 patients with ESRD receiving maintenance hemodialysis were enrolled. WBV was measured using a scanning capillary tube viscometer pre- and post-dialysis to quantify dialytic viscosity surges. Body weight, blood pressure, and hematocrit were also measured before and after hemodialysis, as was the fluid removed during the session. Results: Hemodialysis had a 3 times greater impact on the low-shear WBV at a shear rate of 1 s-1 (i.e., 44.1% change) than on the high-shear WBV at a shear rate of 300 s-1 (i.e., 15.9% change). Changes in the low-shear WBV obtained at shear rates of 1 and 5 s-1 during hemodialysis were significantly correlated with changes in hematocrit. The intravascular blood volume reduction during hemodialysis was positively correlated with the changes in both high-shear and low-shear WBVs. Conclusions: These results suggest that the WBV parameter may hold additional information beyond hemoconcentration. Further research is needed to evaluate the relationship between low-shear WBV surges and increased morbidity in the patient population with ESRD.
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Shirazian S, Rios-Rojas L, Drakakis J, Dikkala S, Dutka P, Duey M, Cho DJ, Fishbane S. The effect of hemodialysis ultrafiltration on changes in whole blood viscosity. Hemodial Int 2012; 16:342-50. [PMID: 22360439 DOI: 10.1111/j.1542-4758.2012.00671.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Increased whole blood viscosity (WBV) can be injurious to the vascular endothelium and increase the risk of atherothrombotic events. This study examined the effect of hemodialysis ultrafiltration (UF) on WBV, with a focus on high vs. low-volume UF patients. In stable hemodialysis patients, blood was drawn for hematocrit (Hct) and WBV at the start, midpoint, and at the end of dialysis. For analysis, patients were divided into high UF (≥2700 mL) or low UF (<2700 mL) groups. A total of 59 patients completed the study. Mean Hct increased during dialysis in both groups. The intradialytic increase in Hct was significantly greater in the high vs. the low UF group (3.2% vs. 1.28%, P = 0.01), with a significantly higher end-dialysis Hct in the high UF group (40.5% vs. 38%, P = 0.02). At the end of dialysis, both high shear rate WBV (P < 0.01) and low shear rate WBV (P < 0.01) were significantly higher in the high UF compared with the low UF group. There was an approximately two-fold greater increase in high shear rate (P < 0.01) and low shear rate (P = 0.01) WBV during dialysis in high vs. low UF groups. The increase in high shear rate WBV during dialysis was significantly correlated with an increase in Hct (R(2) = 0.63, P < 0.01). We found that hemodialysis UF causes a surge in WBV. The surge was of greater magnitude in high than in low UF patients.
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Affiliation(s)
- Shayan Shirazian
- Division of Nephrology, Winthrop University Hospital, Mineola, New York, USA.
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