Abstract: SA-PO345
Extracellular Volume Overload Is Associated With Increased Endothelin-1 in Hypertensive Hemodialysis Patients
Session Information
- Hemodialysis and Frequent Dialysis: CV and Risk Prediction
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Van Buren, Peter N., The University of Texas Southwestern Medical Center Department of Internal Medicine, Dallas, Texas, United States
- Roehm, Bethany Angela, The University of Texas Southwestern Medical Center Department of Internal Medicine, Dallas, Texas, United States
- Sambandam, Kamalanathan Kolandavelu, The University of Texas Southwestern Medical Center Department of Internal Medicine, Dallas, Texas, United States
Background
Extracellular volume (ECV) overload contributes to hypertension in hemodialysis (HD) patients and is associated with increased mortality. The potent vasoconstrictor endothelin-1 (ET-1) is associated with both high HD-unit blood pressure (BP) as well as morbidity and mortality. It is unclear if ECV and ET-1 are related. We sought to determine if ECV predicted ET-1 levels in hypertensive HD patients.
Methods
In a cohort of hypertensive HD patients, we obtained measurements of pre-HD plasma ET-1 and ECV using whole-body multifrequency bioimpedance spectroscopy. We determined the Pearson correlation coefficient between ET-1 and ratio of ECV to body weight (ECV/Wt). We then used linear regression anlaysis with ET-1 as the outcome and ECV/Wt as the predictor variable to determine the independent association between these variables in univariate models as well as models controlling for demographics, interdialytic weight gain, pre-HD systolic BP, and diabetes.
Results
There were 64 participants with a mean age of 48.9 (12) years including 38 men, 56 that were Black or Hispanic, and 37 with diabetes. All had hypertension with mean pre-HD systolic BP 157 (20) mmHg. The mean pre-HD ECV/Wt and ET-1 were 0.26 (0.05) L/kg and 2.38 (1.5) pg/mL, and there was significant correlation between these variables (r=0.3, p=.03). In a model controlling for demographics, there was a significant association between ECV/Wt and ET-1 (β=0.15, p=.002; both variables underwent reciprocal transformation). This significant association was unchanged when controlling for BP, weight gain, and diabetes.
Conclusion
Higher pre-HD ECV/Wt is independently associated with higher ET-1 levels in hypertensive HD patients. This association requires further investigation to establish a potentially novel mechanism related to volume induced hypertension as well as well as therapeutic strategies to consider for patients with hypertension and refractory volume overload.
There is a significant correlation between pre-HD ECV/Wt and ET-1 (r=0.3, p=.03)
Funding
- NIDDK Support