Under physiological circumstances in the common carotid artery (CCA), mean wall shear stress (WSS), defined as mean wall shear rate (WSR) times local whole blood viscosity (WBV), is maintained at approximately 1.5 Pa. In patients with end-stage renal failure (ESRF) whole blood viscosity is low and it is not unlikely that mean WSS is lower in these patients than in control subjects. Moreover, hemodialysis causes an acute increase in blood viscosity with possible effects on WSS. In this study WSS in the CCA was determined with the Shear Rate Estimating System, an apparatus based on ultrasound, in ESRF patients (n = 13) and in presumed healthy age- and sex-matched control subjects (n = 13). Prior to hemodialysis, mean WSS (0.67 ± 0.23 Pa) was significantly lower (p < 0.05) in patients with ESRF, due to both a lower WBV (2.80 ± 0.52 mPa·s) and mean WSR (271 ± 109 s–1), than in the control subjects (mean WSS: 1.24 ± 0.20 Pa; WBV: 3.20 ± 0.29 mPa·s; WSR: 387 ± 51 s–1). Hemodialysis induced an increase in WBV (up to 3.71 ± 1.54 mPa·s, p < 0.01), but mean WSS did not change significantly due to a reciprocal decrease in mean wall shear rate. These findings demonstrate that WSS is lower in hemodialysis patients than in control subjects, and that mean WSS is maintained at this low level despite an acute change in blood viscosity.

1.
Rodbard S: Negative feedback mechanisms in the architecture and function of the connective and cardiovascular tissues. Perspect Biol Med 1970;13:507–527.
2.
Kamiya A, Togawa T: Adaptive regulation of wall shear stress to flow change in the canine carotid artery. Am J Physiol 1980;239:H14–H21.
3.
Zarins CK, Zatina MA, Giddens DP, Ku DN, Glagov S: Shear stress regulation of artery lumen diameter in experimental atherogenesis. J Vasc Surg 1987;5:413–420.
4.
Samijo SK, Willigers JM, Barkhuysen R, Kitslaar PJEHM, Reneman RS, Brands PJ, Hoeks APG: Wall shear stress in the human carotid artery as function of age and gender. Cardiovasc Res 1998;39:515–522.
5.
Seyfert UT, Hauck W, Kirsch J, Kiesewetter H, Albert FW, Wenzel E: Contributions to biorheology during hemodialysis. Biorheology 1991;28:473–481.
6.
Feriani M, Kimmel PL, Kurantsin-Mills J, Bosch JP: Effect of renal replacement therapy on viscosity in end-stage renal disease patients. Am J Kidney Dis 1992;19:131–139.
7.
Brenner BM, Lazarus JM. Chronic renal failure: Pathophysiologic and clinical consequences; in Braunwald E, Isselbacher KJ, Petersdorf RG, Wilson JD, Martin JB, Fauci AS (eds): Harrison’s Principles of Internal Medicine, ed 11. Hamburg, McGraw-Hill, 1987, pp 1155–1161.
8.
Barenbrock M, Spieker C, Laske V, Baumgart P, Hoeks APG, Zidek W, Rahn KH: Effect of long-term hemodialysis on arterial compliance in end-stage renal failure. Nephron 1993;65:249–253.
9.
London GM, Marchais SJ, Safar ME, Genest AF, Geurin AP, Metevier F, Chedid K, London AM: Aortic and large artery compliance in end-stage renal failure. Kidney Int 1990;37:137–142.
10.
Caro CG, Fitzgerald JM, Schroter RC: Atheroma and arterial wall shear: Observation, correlation and proposal of a shear dependent mass transfer mechanism for atherogenesis. Proc R Soc Lond 1971;17B:105–159.
11.
Friedman MH, Hutchins GM, Bargeron CB, Deters OJ, Mark FF: Correlation between intimal thickness and fluid shear in human arteries. Atherosclerosis 1981;39:425–436.
12.
London GM, Drueke TB: Atherosclerosis and arteriosclerosis in chronic renal failure. Kidney Int 1997;51:1678–1695.
13.
Lindner A, Charra B, Sherrard D, Scribner BH: Accelerated atherosclerosis in prolonged maintenance hemodialysis. N Engl J Med 1974;290:697.
14.
Nicholls AJ, Edward N, Catto GRD, Engeset J, Macleod M: Accelerated arteriosclerosis in long-term dialysis and renal transplant patients: Fact or fiction? Lancet 1980;i:276–278.
15.
Melkumyants AM, Balashov SA: Effect of blood viscosity on arterial flow-induced dilator response. Cardiovasc Res 1990;24:165–168.
16.
Brands PJ, Hoeks APG, Hofstra L, Reneman RS: A noninvasive method to estimate wall shear rate using ultrasound. Ultrasound Med Biol 1995;21:171–185.
17.
Hoeks APG, Samijo SK, Brands PJ, Reneman RS: Assessment of wall shear rate in humans: An ultrasound study. J Vasc Invest 1995;1:108–117.
18.
Reneman RS, Van Merode T, Hick P, Hoeks APG: Flow velocity patterns in and distensibility of the carotid artery bulb in subjects of various ages. Circulation 1985;71:500–509.
19.
Samijo SK, Willigers JM, Brands PJ, Barkhuysen R, Reneman RS, Kitslaar PJEHM, Hoeks APG: Reproducibility of shear rate and shear stress assessment by means of ultrasound in the common carotid artery of young human males and females. Ultrasound Med Biol 1997;23:583–590.
20.
Weaver JPA, Evans A, Walder DN: The effect of increased fibrinogen content on the viscosity of blood. Clin Sci 1969;36:1–10.
21.
Zarins CK, Giddens DP, Bharavadj BK, Sottiurai VS, Mabon RF, Glagov S: Carotid bifurcation atherosclerosis: Quantification of plaque localization with velocity profiles and wall shear stress. Circ Res 1983;53:502–514.
22.
Kornet l, Lambregts J, Hoeks APG, Reneman RS: Differences in near wall shear rate in the carotid artery within subjects are associated with different intima-media thickness. Arterioscler Thromb Vasc Biol 1998;18:1877–1884.
23.
Kornet L, Hoeks APG, Lambregts J, Reneman RS: In the femoral artery bifurcation, differences in mean wall shear stress within subjects are associated with different intima-media thickness. Arterioscler Thromb Vasc Biol 1999;19:2933–2939.
24.
Chowienczyk PJ, Watts GF, Cockcroft JR, Ritter JM: Impaired endothelium-dependent vasodilation of forearm resistance vessels in hypercholesterolemia. Lancet 1992;340:467–471.
25.
Moncada S, Palmer RM, Higgs EA: Nitric oxide: Physiology, pathophysiology and pharmacology of nitric oxide. Pharmacol Rev 1991;43:109–142.
26.
Wever N, Boer P, Hijmering M, Stroes E, Verhaar M, Kastelein J, Versluis K, Lagerwerf F, Van Rijn H, Koomans H, Rabelink T: Nitric oxide production is reduced in patients with end-stage renal failure. Arterioscler Thromb Vasc Biol 1999;19:1168–1172.
27.
Melkumyants AM, Balashov SA, Khayutin VM: Endothelium-dependent control of the arterial diameter by blood viscosity. Cardiovasc Res 1989;23:741–747.
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