Affiliations: Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA | Section of Nephrology, Department of Medicine, University of Chicago, Chicago, IL, USA | Department of Biosystem Engineering, University of Arizona, Tucson, AZ, USA
Note: [] Corresponding author: Mary Hammes, D.O., Associate Professor of Medicine, University of Chicago MC 5100, 5841 S Maryland Ave., Chicago, IL 60637, USA. Tel.: +1 773 702 9892; Fax: +1 773 702 5818; E-mail: mhammes@medicine.bsd.uchicago.edu
Abstract: Background: Hemodialysis patients have increased mortality from cardiovascular complications. Whole blood viscosity (WBV) and red cell aggregation (RCA) may influence the pathogenesis of vascular complications in this population. The objective of this study was to determine whether the hemodialysis treatment or vascular complications were associated with impaired WBV or RCA. Methods: This prospective, cross sectional investigation included 38 patients receiving chronic hemodialysis. Blood samples for WBV, RCA and hematocrit were drawn before and after dialysis. WBV was determined between 10 and 780 s−1 and RCA was measured by calculating aggregate shape parameter. WBV and RCA were subsequently assessed for correlation with a history of vascular disease. Results: The mean WBV, aggregate shape parameter, and hematocrit post-dialysis were significantly higher than pre-dialysis values (p < 0.05). Using a linear model with WBV as the dependent variable, the covariates of aggregate shape parameter, hematocrit, weight, and history of diabetes were not significant. However, pre/post timing of the sample was a significant covariate. WBV correlated with prior access thrombosis or stenosis, especially if the patient had a history of peripheral vascular disease. Conclusions: Higher WBV correlated with an increased incidence of access failure and vascular disease. Repetitive increases in WBV and RCA with each dialysis treatment could contribute to vascular dysfunction in this patient population.
Keywords: Access failure, end stage renal disease, hemodialysis, red cell aggregation, vascular disease, viscosity
