Vascular Function at Baseline in the Hemodialysis Fistula Maturation Study

Background: end-stage renal disease is accompanied by functional and structural vascular abnormalities. the objective of this study was to characterize vascular function in a large cohort of patients with end-stage renal disease,using noninvasive physiological measurements,and to correlate function with demographic and clinical factors.methods and results: we analyzed cross-sectional baseline data from the hemodialysis fistula maturation study,a multicenter prospective observational cohort study of 602 patients with end-stage renal disease from 7 centers. brachial artery flow- and nitroglycerin-mediated dilation,carotid-femoral and -radial pulse wave velocity,and venous occlusion plethysmography were performed prior to arteriovenous fistula creation. relationships of these vascular function measures with demographic,clinical,and laboratory factors were evaluated using linear mixed-effects models. arterial function,as assessed by flow- and nitroglycerin-mediated dilation and carotid-femoral pulse wave velocity,worsened with increasing age and diabetes mellitus. venous capacitance decreased with diabetes mellitus but not with age. flow-mediated dilation was higher among patients undergoing maintenance dialysis than for those at predialysis,and a u-shaped relationship between serum phosphorus concentration and flow-mediated dilation was evident. partial correlations among different measures of vascular function,adjusting for demographic factors,diabetes mellitus,and clinical center,were modest or essentially nonexistent.conclusions: multiple demographic and clinical factors were associated with the functions of vessels of different sizes and types in this large cohort of patients with end-stage renal disease. low correlations between the different measures,controlling for demographic factors,diabetes mellitus,and center,indicated that these different types of vascular function otherwise vary heterogeneously across patients. © 2016 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.