Influence of Hemodialysis on Endothel-Depending Dilatation of Peripheral Arteries
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Purpose
An impairment of nitric oxide (NO) bioavailability is associated with endothelial dysfunction and may contribute to the excessive incidence of cardiovascular complication in chronic haemodialysis (HD) patients. It is not known whether cell-free hemoglobin limits nitric oxide bioavailability during HD.
| Condition | Intervention |
|---|---|
|
Hemodialysis |
Procedure: blood sample Procedure: Flow-mediated dilation (FMD) before and after a single HD |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Basic Science |
| Official Title: | Angiologic Study of the Influence of Hemodialysis on Endothelial Function |
- influence of hemodialysis on endothelial function as determined by plasma nitrite concentration [ Time Frame: before and after hemodialysis ] [ Designated as safety issue: No ]
- influence on hemodialysis on endothelial function as determined by measurement of flow-mediated dilation (FMD) of teh brachial artery using high resolution ultrasound [ Time Frame: before and after hemodialysis ] [ Designated as safety issue: No ]
| Enrollment: | 14 |
| Study Start Date: | October 2006 |
| Study Completion Date: | October 2007 |
| Primary Completion Date: | February 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
14 HD patients are studied before and after a single HD using a polysulphone dialyser.
|
Procedure: blood sample
blood sample before and after a single HD
Other Name: biochemistry
Procedure: Flow-mediated dilation (FMD) before and after a single HD
measuring of the flow-mediated dilation using high-resolution ultrasound
Other Name: endothelial function
|
Detailed Description:
Cardiovascular complications are the major cause of death in end-stage renal disease (ESRD) patients undergoing chronic haemodialysis (HD).1 During haemodialysis (HD) the endothelium is the first organ to sense and to be impaired by mechanical and immunological stimuli.2 Adequate endothelial function and integrity reduce thromboembolic events, while endothelial dysfunction is an early key step in the development of atherosclerosis3-5, is involved in plaque progression6 and has been attributed to impaired nitric oxide (NO) bioactivity and enhanced formation of oxygen-derived free radicals.7 Given that endothelial dysfunction is at least in part reversible, the assessment of altered NO availability is of important diagnostic and prognostic significance and may deepen the understanding of cardiovascular disease in HD.8 Nitric oxide bioavailability has been shown to be limited by cell-free hemoglobin.9 The rates of NO consumption by cell-free and intraerythrocytic hemoglobin suggest that only when hemoglobin is physically compartmentalized within erythrocytes will NO produced by endothelial cells reach concentrations within smooth muscle necessary to activate guanylyl cyclase and cause vasodilation.10;11 However, the rate of NO scavenging is reduced 1,000-fold by sequestering hemoglobin within the red cell membrane.12;13 This mechanism is believed to be important in various conditions of health and disease.14-16 In ESRD intravascular hemolysis during HD has been described.17-19
Eligibility| Ages Eligible for Study: | 21 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- patients older 21 years dependent on HD for more than 6 months
Exclusion Criteria:
- known HD associated hypotension intake of nitrate
Contacts and Locations| Germany | |
| University Hospital | |
| Aachen, NRW, Germany, 52074 | |
| Principal Investigator: | Christian Meyer, MD | RWTH Aachen University, Medical Clinic I |
More Information
No publications provided by RWTH Aachen University
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Christian Meyer, MD, RWTH Aachen University, Medical Clinic I, University Hospital |
| ClinicalTrials.gov Identifier: | NCT00764192 History of Changes |
| Other Study ID Numbers: | EK DD 2022 CM |
| Study First Received: | September 26, 2008 |
| Last Updated: | January 12, 2009 |
| Health Authority: | Germany: Ethics Commission |
Keywords provided by RWTH Aachen University:
|
hemodialysis Flow-mediated dilation nictric oxide endothelial function |
ClinicalTrials.gov processed this record on May 21, 2013