Acute improvement of aortic mechanics following hemodialysis in patients with chronic renal failure

Background: Evidence suggests that distensibility of the aorta is decreased in patients with end-stage renal failure, while the underlying mechanisms are unclear. Hypothesis: The purpose of the study was to evaluate the distensibility of the aorta in patients at the end stage of chronic renal failure before and after hemodialysis (HD). Methods: The diameter of the ascending aorta and distensibility were assessed in 48 patients on HD (31 men, 17 women, aged 45 14 years) and in 27 normal subjects (17 men, 10 women, aged 44 +/- 14 years). The diameter of the aorta was evaluated by M-mode in the parasternal long-axis view. Results: Aortic distensibility was significantly lower in patients on HD before HD (1.9 +/- 0.7 cm(2.)dyn(-1.)10(-6)) than in normal control subjects (3.8 +/- 1.0 cm(2.)dyn(-1.)10(-6), p < 0.0001). After dialysis, it increased to 2.6 +/- 1.2 (p < 0.05 compared with baseline, p < 0.001 compared with controls). The change of aortic distensibility correlated with age (R-2 = 0.629 p < 0.001) and ultrafiltration volume (R-2 = 0.168, p < 0.01). Conclusions: Aortic distensibility in patients with endstage renal disease is significantly lower than in normal subjects, and it is significantly improved after HD

Acute improvement of aortic mechanics following hemodialysis in patients with chronic renal failure.

BACKGROUND: Evidence suggests that distensibility of the aorta is decreased in patients with end-stage renal failure, while the underlying mechanisms are unclear. HYPOTHESIS: The purpose of the study was to evaluate the distensibility of the aorta in patients at the end stage of chronic renal failure before and after hemodialysis (HD). METHODS: The diameter of the ascending aorta and distensibility were assessed in 48 patients on HD (31 men, 17 women, aged 45+/-14 years) and in 27 normal subjects (17 men, 10 women, aged 44+/-14 years). The diameter of the aorta was evaluated by M-mode in the parasternal long-axis view. RESULTS: Aortic distensibility was significantly lower in patients on HD before HD (1.9+/-0.7 cm(2) x dyn(-1) x 10(-6)) than in normal control subjects (3.8+/-1.0 cm(2) x dyn(-1) X 10(-6), p< 0.0001). After dialysis, it increased to 2.6+/-1.2 (p < 0.05 compared with baseline, p < 0.001 compared with controls). The change of aortic distensibility correlated with age (R(2) = 0.629 p < 0.001) and ultrafiltration volume (R(2) = 0.168, p < 0.01). CONCLUSIONS: Aortic distensibility in patients with end-stage renal disease is significantly lower than in normal subjects, and it is significantly improved after HD

Soluble Fas antigen and soluble Fas ligand in early neonatal life

Background: After birth, apoptosis rates might slow down, compared to those in utero. Thus, factors, attenuating the apoptotic process, like the soluble. forms of Fas/FasL system, may increase. Aim-study design: Soluble Fas (sFas) and soluble Fas ligand (sFasL) concentrations were measured in maternal serum (MS), umbilical cord (UC) and neonatal serum in the first (IN) and fifth (5N) days after birth in order to evaluate the alterations of these molecules during the early neonatal period. Subjects and methods: Soluble molecules were estimated-in 35 healthy, appropriate for gestational age, full-term neonates, their mothers and in 25 healthy, nonpregnant women, age-matched to the mothers (controls), using enzyme immunoassays. Results: sFas concentrations in MS (p &lt; 0.01), UC (p &lt; 0.000 1), IN (p &lt; 0.0003) and 5N (p &lt; 0.02) were lower than those in controls. Neonatal sFas concentrations showed a significant increase from UC to 5N (p&lt;0.001). In contrast, sFasL concentrations were significantly elevated in all neonatal samples (UC, IN and 5N) compared to those in MS and controls (p&lt;0.0001), showing also a significant elevation from UC to 5N (p&lt;0.0001). Conclusion: Our results demonstrate increasing serum concentrations of the soluble molecules sFas and sFasL during the first days after birth, indicating possibly a gradual decrease of apoptosis in early neonatal life. (C) 2003 Elsevier Ireland Ltd. All rights reserved