Association of hyperphosphataemia with haemodynamic disturbances in end-stage renal disease

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Abstract
Background. Because recent data demonstrated that the shortened survival and excess cardiovascular death of end-stage renal disease (ESRD) patients are predicted by hyperphosphataemia, we examined the haemodynamic alterations associated with high serum phosphorus levels in ESRD patients on haemodialysis. Methods. Sixty-six ESRD patients were studied. Patients were separated arbitrarily into two groups, i.e. with predialysis serum phosphate 2 mmol/l (`high' phosphate). Cardiac and arterial function and structure were analysed by computer-assisted ultrasonography. Results. Hyperphosphataemic patients were characterized by higher diastolic and mean blood pressures (P PPPPP=0.07), but similar carotid artery intima-media thickness, and lower carotid wall-to-lumen ratio (PPConclusion These findings suggest that, in stable ESRD patients, hyperphosphataemia is associated with increased BP, hyperkinetic circulation, increased cardiac work, and high arterial tensile stress. These haemodynamic abnormalities could favour the development of cardiovascualr complications and contribute to high cardiovascular morbidity and mortality.