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Objective: To investigate the proportion of arterial stiffness in patients on twice weekly maintenance hemodialysis and the factors affecting it. Methodology: This observational study with a cross-sectional design was performed in the Haemodialysis Unit, Kidney and Hypertension Division, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia. The study enrolled 83 End Stage Renal Disease (ESRD) patients undergoing hemodialysis two times a week for at least three months. Patients with acute disease were excluded from the study. Arterial stiffness was measured as pulse wave velocity (PWV) using SphygmoCor® with PWV cut-off of 10m/s. SPSS 21.0 was used as an analysis tool; descriptive and inferential statistics were applied where needed. Results: In the sample, 42 (50.6%) were male and 41 were female (49.4%). Among all participants, 22 (26.5%) patients were with arterial stiffness and 61 (73.5%) were without arterial stiffness. Factors independently affecting arterial stiffness were fasting glucose level (odds ratio 6.842 [CI95% 1.66-28.24]) and LDL level (odds ratio 4.887 [CI95% 1.59-16.58]). Conclusion: The proportion of arterial stiffness in ESRD patients undergoing hemodialysis two times a week was about one third of all patients. In factors affecting arterial stiffness among ESRD patients, fasting glucose level and LDL level were found to have higher odds. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic limb threatening ischemia (CLTI) and end-stage renal disease (ESRD) have greater risk of limb loss compared to those with CLTI alone. We investigated angiographic patterns in patients with CLTI and evaluated for differences based on ESRD status.Methods: We reviewed lower extremity angiograms of 152 CLTI patients at a single academic medical center from 2011 to 2017 and analyzed them based on the Graziani and Bollinger classification systems. We used these classification systems to evaluate for angiographic patterns and arterial disease severity categorized by the presence or absence of ESRD.Results: The analysis included 152 CLTI patients (161 angiograms). Patients' mean age was 63.4 ± 11.3 years and 20 (12.4%) patients had ESRD. In our study population, infrapopliteal arterial disease was more severe than femoropopliteal disease. Disease of the arteries providing direct flow to the plantar arch was more severe in ESRD patients compared to non-ESRD patients, evident by higher Graziani Class VII disease (20% vs. 4.9%, p = .03). ESRD patients also had higher rates of concurrent significant stenosis of the posterior tibial and lateral plantar arteries (70% vs. 23%, p < .0001).Conclusion: In people with CLTI, infrapopliteal arteries are more severely affected than proximal femoropopliteal arteries. ESRD patients exhibit a pattern of arterial disease, we termed the "renal foot," that frequently involves arteries providing direct flow to the plantar arch. [ABSTRACT FROM AUTHOR]

BACKGROUND: Arterial stiffening is a major contributing factor in the development of cardiovascular disease in patients with end-stage renal disease (ESRD). However, there is no gold standard for evaluating arterial stiffness. This study aimed to evaluate the newly developed speckle-tracking carotid strain imaging method in assessing arterial stiffness in patients with ESRD. METHODS: In total, 85 patients with normal renal function (controls) and 36 with ESRD were enrolled in this single-center study. Carotid B-mode ultrasonography was performed for all patients. Arterial stiffness indices and strain parameters of the common carotid arteries were analyzed. Values were compared between the groups, and multivariate linear regression analysis was performed to assess the impact of ESRD on carotid strain. RESULTS: There were no differences in the intima-media thickness, ß stiffness index, and arterial compliance, but arterial distensibility was lower, and the elastic modulus and pulse wave velocity ß (PWV) were higher among patients with ESRD (all p < 0.05), whether assessed in the longitudinal or transverse plane. Both longitudinal and transverse strain rates were reduced in patients with ESRD (all p < 0.05). In multivariate analyses, ESRD independently reduced both transverse radial strain and strain rate (all p < 0.05), and the transverse circumferential strain and strain rate (p < 0.05). However, all conventional aortic stiffness indices and longitudinal strain parameters were not associated with ESRD. CONCLUSIONS: Speckle-tracking carotid strain ultrasonography was successfully performed in both normal subjects and patients with ESRD. Multidirectional carotid strain analyses may provide more value than conventional aortic stiffness indices for risk stratification in patients with ESRD. [ABSTRACT FROM AUTHOR]