Carotid artery elasticity in hemodialysis-induced hypotension

Background: The hypothesis was tested that carotid artery distensibility an d compliance were less in patients developing dialysis-induced hypotension than in other dialyzed patients, and that reduced distensibility was associ ated with impaired baroreflex function. Methods: Twenty-three end-stage renal disease (ESRD) patients undergoing he modialysis treatment were studied. They were divided into two groups: patie nts who developed hypotension (DH, n = 8) and patients who did not (non-DH, n = 15). Dynamic elastic properties of the common carotid artery (measured with an automated vessel wall-movement detector system) and baroreflex sen sitivity (measured non-invasively, using spontaneously occurring fluctuatio ns in arterial blood pressure) were determined before dialysis as well as e very 30 minutes during the dialysis period. Results: In the DH patients, the fall in arterial pressure was not accompan ied by carotid artery recoil, i.e., reduction in diameter: Additionally, no differences were found between carotid dynamic distensibility and barorefl ex sensitivity among the DH and non-DH patients. Conclusion: It is concluded that the static pressure-diameter relation of t he carotid artery is altered in ESRD, but that carotid dynamic distensibili ty, and baroreflex sensitivity do not differentiate between DH and non-DH p atients.