TY - JOUR AU - Soveri , Inga AU - Kals , Jaak PY - 2015/05/07 Y2 - 2024/03/29 TI - Low dialysate potassium and central arterial pressure waveform JF - Upsala Journal of Medical Sciences JA - ujms VL - 120 IS - 3 SE - Original Articles DO - 10.3109/03009734.2015.1037031 UR - https://ujms.net/index.php/ujms/article/view/5864 SP - AB - Background. Cardiovascular mortality is high in hemodialysis (HD) patients. Early arterial pressure wave reflections predict mortality inHDpatients, andHDacutely improves the central pressure waveform. Potassium (K) plays a crucial role in cardiac electrophysiology, and patients with end-stage kidney disease depend on HD for neutral K balance. We aimed to study the impact of dialysate K concentrations on central arterial pressure waveform.Methods. Thirty-three chronic HD patients were studied before and after a HD session, and the prescribed dialysate K concentration was recorded. In a subset of 23 patients without arrhythmias, pulse wave analysis was performed on radial arteries. Nine patients had dialysate K set to 1 mmol/L (group 1), and 14 patients had K set to 2 or 3 mmol/L (group 2). Augmentation index (AIx), defined as difference between the second and first systolic peak divided by central pulse pressure, was used as a measure of arterial stiffness.Results. HD reduced the AIx in group 1 only (p = 0.0005). Likewise, central systolic pressure was reduced in group 1 only (p = 0.006). The relative reduction of AIx post-HD was significantly higher in group 1 compared with group 2 (p < 0.0001). The association between low dialysate K and AIx reduction remained statistically significant after adjustment for variables including the change in central and peripheral systolic pressure and mean arterial pressure.Conclusion. Low dialysate K is strongly and independently associated with the acute improvement of AIx. ER -